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Metabolic syndrome and hemorrhagic stroke among symptomatic CCMs in the Mexican Hispanic Population

Dwivedi, A. K.; Jang, D.; Belkin, O.; Aickareth, J.; Renteria, M.; Hawwar, M.; Croft, J.; Kalas, M. A.; Zuckerman, M. J.; Zhang, J.

2023-05-16 neurology
10.1101/2023.05.15.23289984 medRxiv
Show abstract

Cerebral cavernous malformations (CCMs) are neurological disorders that make individuals more susceptible to hemorrhagic stroke. The Mexican-Hispanic population has a higher prevalence of both CCMs and metabolic syndrome (MetS), which is also associated with hemorrhagic stroke. A study was conducted with 184 Mexican-Hispanic CCM subjects and age- and sex-matched Hispanic and non-Hispanic white controls. The CCM cohort had a higher proportion of epilepsy and hemorrhagic stroke but a lower proportion of MetS. Higher blood pressure and fasting glucose levels were observed in the CCM cohort. MetS and epilepsy were associated with increased odds of hemorrhagic stroke among elderly CCM patients, and increased systolic blood pressure was significantly linked to increased odds of hemorrhagic stroke in the CCM cohort. To minimize the risk of hemorrhagic stroke, it is important to manage blood pressure and comorbidities like MetS and epilepsy in CCM patients, particularly those older than 50. SUMMARUYO_ST_ABSWhat is already known about this subjectC_ST_ABSO_LIMetabolic Syndrome (MetS) is widely associated with cardiovascular conditions, including stroke, C_LIO_LIThe association between MetS and ischemic stroke is well established C_LIO_LIThe relationship between MetS and hemorrhagic stroke remains unclear C_LIO_LICurrently, one two studies explored the relationship between MetS and hemorrhagic stroke in CCM patients; one n sporadic CCM (sCCM) and one in familial CCM cases, with inconsistent results. C_LI What are the new findingsO_LIIn this study, a strong association was observed between systolic blood pressure (SBP) and hemorrhagic stroke in the CCM cohort, independent of obesity or fasting glucose levels. C_LIO_LIThis study also suggests that MetS is associated with hemorrhagic stroke among CCM patients, specifically in the older age group. C_LI How might it impact on clinical practice in the foreseeable futureO_LIThis study demonstrates many of the unique characteristics of symptomatic CCMs within the Mexican-Hispanic population C_LIO_LIOur results suggests that of Mexican-Hispanic CCM subjects are at a greater risk for hemorrhagic stroke and epilepsy than other ethnic groups. C_LIO_LIThis study highlights the importance of reducing blood pressure and managing comorbidities such as MetS and epilepsy in CCM patients, especially those who are older than 50 years to minimize the risk of hemorrhagic stroke among CCM subjects C_LI

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