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Individuals with CVD have high risk for adverse cognitive outcomes and stroke, possibly due to shared risk factors between CVD, stroke, and dementia, which may be attributed to cerebral small vessel disease (CSVD). We aim to determine the association between prevalent CVD and atrial fibrillation (AF) with CSVD. Methods: Composite of CVD [coronary heart disease, heart failure (HF)], its individual components, and AF were assessed. Multi-marker CSVD score was used to reflect increasing CSVD burden (cerebral microbleeds (CMBs), high-burden perivascular spaces, extensive white matter hyperintensity, cortical superficial siderosis, or covert brain infarcts were assigned 1 point each, with a range of 0\u20135). We related prevalent CVD, its individual components, and AF to multi-marker CSVD score and individual CSVD markers using logistic regression analyses adjusted for age, sex, FHS cohort, time between MRI and clinic exam (model-1), and vascular risk factors (model-2). Results: In 3413 participants (mean age: 59 \u00b1 14 years, 53.4% women), 11% had prevalent CVD or AF, 8% had prevalent CVD, and 4% had prevalent AF. One CSVD marker was seen in 23% participants, and 9% had \u2265 2 markers. In multivariable-adjusted analyses, composite prevalent CVD and AF was associated with the presence of one CSVD marker (OR: 1.38, 95% confidence interval [CI]: 1.05\u20131.84). The association with \u22652 CSVD markers was not significant. Only CMBs were associated with components of CVD and AF, with the highest odds of association with HF. Conclusions: Prevalent CVD (including AF) is associated with the presence of CSVD, with all components associated with CMBs.<\/jats:p>","DOI":"10.3390\/brainsci15080813","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T09:31:45Z","timestamp":1753781505000},"page":"813","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalent Cardiovascular Disease and Atrial Fibrillation in Relation to Cerebral Small Vessel Disease Burden"],"prefix":"10.3390","volume":"15","author":[{"given":"Oluchi","family":"Ekenze","sequence":"first","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adlin","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa S.","family":"Beiser","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8521-0036","authenticated-orcid":false,"given":"Vasileios-Arsenios","family":"Lioutas","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8584-1455","authenticated-orcid":false,"given":"Hugo J.","family":"Aparicio","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Section of Cardiovascular Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramachandran S.","family":"Vasan","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas at San Antonio, San Antonio, TX 78229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-2693","authenticated-orcid":false,"given":"Charles","family":"DeCarli","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California at Davis, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudha","family":"Seshadri","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"},{"name":"The Glenn Biggs Institute for Alzheimer\u2019s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX 78229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serkalem","family":"Demissie","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose R.","family":"Romero","sequence":"additional","affiliation":[{"name":"NHLBI\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e347","DOI":"10.1161\/CIR.0000000000001209","article-title":"2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart 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