{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:29:42Z","timestamp":1781623782030,"version":"3.54.5"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Mild manifestations of individual cerebral small vessel disease (CSVD) markers are common and may not denote increased risk, but high CSVD burden identifies individuals at increased risk of stroke and dementia. Scores incorporating multiple individual CSVD markers may better identify a person\u2019s risk. We related a multimarker CSVD score to risk of incident stroke and compared it with the Framingham Stroke Risk Profile (FSRP) in community\u2010dwelling individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Framingham Heart Study participants aged \u226555\u2009years, free of stroke and dementia, and with brain magnetic resonance imaging ratings of CSVD markers were included. A multimarker CSVD score reflecting increasing CSVD burden was used, assigning 1 point each for presence of cerebral microbleeds, severe perivascular spaces, extensive white matter hyperintensities, covert brain infarcts, and cortical superficial siderosis. Multivariable Cox proportional hazards regression analyses were used to relate CSVD score to incident stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 1154 participants (46% men, mean age 70.9\u00b18.7\u2009years), 92 (8%) developed stroke over a median follow\u2010up of 8.6\u2009years (Q1\u2013Q3: 5.1\u201312.5). In models adjusting for age, sex, time interval between clinic exam and magnetic resonance imaging, Framingham cohort, and FSRP, those with \u22653 markers had increased risk of stroke (hazard ratio [HR], 2.62 [95% CI, 1.17\u20135.88]). In comparison, a 5% increase in FSRP was also associated with increased risk (adjusted HR, 1.16 [95% CI, 1.04\u20131.29]). The FSRP and CSVD score had similar model discrimination metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher CSVD burden is associated with increased risk of stroke, beyond the effect explained by risk factors in the FSRP. These findings support consideration of CSVD burden to identify risk of stroke in community\u2010dwelling individuals for early implementation of preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040263","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:03:48Z","timestamp":1762430628000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Higher Burden of Cerebral Small Vessel Disease Is Associated With Risk of Incident Stroke in Community\u2010Dwelling Individuals"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4241-9198","authenticated-orcid":false,"given":"Adlin","family":"Pinheiro","sequence":"first","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]},{"name":"Framingham Heart Study","place":["Framingham, 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