{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:06:14Z","timestamp":1785229574505,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">This study explored the risk factors, neuroimaging features, and prognostic implications of nonhypertensive white matter hyperintensity (WMH) in patients with acute ischemic stroke and transient ischemic attack.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 2283 patients with hypertension and 1003 without from a pool of 10\u2009602. Associations of moderate\u2010to\u2010severe WMH with known risk factors, functional outcome, and a composite of recurrent stroke, myocardial infarction, and all\u2010cause mortality were evaluated. A subset of 351 patients without hypertension and age\u2010 and sex\u2010matched pairs with hypertension and moderate\u2010to\u2010severe WMH was created for a detailed topographic examination of WMH, lacunes, and microbleeds. Approximately 35% of patients without hypertension and 65% of patients with hypertensive stroke exhibited moderate\u2010to\u2010severe WMH. WMH was associated with age, female sex, and previous stroke, irrespective of hypertension. In patients without hypertension, WMH was associated with initial systolic blood pressure and was more common in the anterior temporal region. In patients with hypertension, WMH was associated with small vessel occlusion as a stroke mechanism and was more frequent in the periventricular region near the posterior horn of the lateral ventricle. The higher prevalence of occipital microbleeds in patients without hypertension and deep subcortical lacunes in patients with hypertension were also observed. Associations of moderate\u2010to\u2010severe WMH with 3\u2010month functional outcome and 1\u2010year cumulative incidence of the composite outcome were significant (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), although the latter lost significance after adjustments. The associations between WMH and outcomes were consistent across hypertensive status.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">One\u2010third of patients without hypertension with stroke have moderate\u2010to\u2010severe WMH. The pathogenesis of WMH may differ between patients without and with hypertension, but its impact on outcome appears similar.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030515","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T11:28:21Z","timestamp":1701170901000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Nonhypertensive White Matter Hyperintensities in Stroke: Risk Factors, Neuroimaging Characteristics, and Prognosis"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6157-2908","authenticated-orcid":false,"given":"Jae\u2010Sung","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Neurology, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of 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