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Small vessel disease (SVD) is a major contributor to stroke and cognitive impairment and frequently coexists with atherosclerosis due to shared vascular risk factors and overlapping pathophysiological mechanisms. This meta-analysis aimed to systematically evaluate the association between atherosclerotic risk factors and the development of SVD in adult and elderly populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed, ScienceDirect, Elsevier, and Google Scholar were searched for eligible studies published between January 2000 and October 2023. Community-based randomized controlled trials and observational studies assessing atherosclerotic risk factors and SVD-related outcomes, primarily carotid intima-media thickness and carotid plaque, were included. Data were pooled using a random-effects model. Heterogeneity was assessed using the I\u00b2 statistic, and publication bias was evaluated using funnel plots and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 11 studies with sample sizes ranging from 50 to 5,585 participants, age and hypertension consistently demonstrated the strongest associations with SVD. Age showed an odds ratio of 1.07 (95% CI: 1.03\u20131.11;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001), while hypertension yielded a pooled odds ratio of 2.24 (95% CI: 1.90\u20132.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Diabetes was also significant (OR 1.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), whereas metabolic syndrome was not (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study concludes that hypertension, age, diabetes mellitus, and carotid atherosclerotic markers\u2014particularly carotid plaque\u2014are significant predictors of SVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05586-2","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T04:05:43Z","timestamp":1770264343000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for small vessel disease in adults with atherosclerosis: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Longdi","family":"Yao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingwen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiran","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianlang","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"5586_CR1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.7326\/0003-4819-55-1-33","volume":"55","author":"WB Kannel","year":"1961","unstructured":"Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J 3. 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