Cerebral small vessel disease: Cross-ethnic comparison between Chinese and White populations.

Aim: Ethnic differences have been reported between Asians and Whites in the prevalence of stroke subtypes. However, it is unknown if population differences exist for manifestations of cerebral small vessel disease. We compared the prevalence and risk of white matter hypertensities (WMH), lacunes, and microbleeds between Han Chinese and White Australian individuals randomly selected from their respective populations. Method(s): Magnetic resonance imaging (1.5-Tesla) was performed on participants of the Shanghai Aging Study (n = 321, mean age 69 +/- 6 years) and Tasmanian Study of Cognition and Gait (n = 397, mean age 72 +/- 7 years). A single expert rater recorded measures of WMH, lacunes, and microbleeds. We also compared lesion prevalence between age- and gender-matched subgroups from the two cohorts. Among all subjects (n = 718), we performed multiple logistic regression, adjusted for putative risk factors, to examine if ethnicity was independently associated with these lesions. Result(s): The prevalence rates of confluent WMH, lacunes, and microbleeds among Chinese and Whites were 37% vs. 34% (p = 0.09), 29% vs. 34% (p = 0.24) and 9% vs. 11% (p = 0.59), respectively. Subgroup analysis among age- and gender-matched subjects showed that confluent WMH was significantly more common among Chinese (38.5%) than Whites (28.4%, p = 0.01). In multiple logistic regression, Chinese ethnicity was associated with a higher risk of confluent WMH (odds ratio 1.7, 95% confidence interval 1.1-2.6, p = 0.01). No differences were seen for lacunes and microbleeds. Conclusion(s): In this population-based cross-national comparison, Han Chinese had a greater risk of confluent WMH than White Australians, but a similar risk of lacunes and microbleeds.