Cerebral amyloid angiopathy in Chinese: Incidence and significance

doi:10.1016/0303-8467(91)90004-9

Clinical Neurology and Neurosurgery

Volume 93, Issue 1, 1991, Pages 19-23

https://doi.org/10.1016/0303-8467(91)90004-9 Get rights and content

Abstract

Histological sections of 210 randomly selected autopsy brains and 49 consecutive autopsy cases of spontaneous intracerebral haemor-rhage in the Chinese population aged over 40 years were examined by H&E and congo red stain with and without polarized light. In the randomly selected group, 10% of cases are positive for cerebral amyloid angiopathy (CAA) while 8.2% of cases are positive in the group with haemorrhage. The incidence is strongly age-related. Compared with Western figures, Chinese are less frequently and less severely affected by CAA. Although CAA does account for some cases of spontaneous intracerebral haemorrhage, it cannot account for the high incidence of cerebral haemorrhage among Chinese. Its significance in Chinese is much lower than in Caucasians.

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1997, Journal of the Neurological Sciences
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The apolipoprotein E (APOE) polymorphism is an established risk factor for intracerebral hemorrhage (ICH) that is related to cerebral amyloid angiopathy in the white population. Among Asian populations, although ICH represents up to one third of all strokes and has high rates of mortality and morbidity, the role of the APOE polymorphism has not been well studied.
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During the 3.9 years of follow-up, ICH occurred in 99 patients. Overall, carrying an ɛ2 or ɛ4 allele of the APOE polymorphism was associated with an adjusted hazard ratio (HR_a) of 1.85 (95% CI = 1.24 to 2.76). In Asian patients the risk of ICH for ɛ2 or ɛ4 carriers was 2.11 (95% CI = 1.28 to 3.47) and 1.48 (95% CI = 0.76 to 2.87) in Europeans. Carriers of the ɛ2 or ɛ4 allele had an increased risk of both incident and recurrent ICH, and both cortical and deep ICH, and most risk estimates were higher in Asians than in Europeans. For both ethnic groups and for subtypes of ICH active treatment more than halved the risk of ICH and the treatment effects were not different in carriers of the ɛ2 or ɛ4 allele and in those with the ɛ3ɛ3 genotype.
There is a strong association between APOE genotype and the risk of intracerebral hemorrhage (ICH). In Asian patients the role of APOE polymorphisms in ICH is much broader than was previously supposed.
ACE = angiotensin converting enzyme; BP = blood pressure; CAA = cerebral amyloid angiopathy; DBP = diastolic blood pressure; ICD9 = 9th Revision of the International Classification of Diseases; ICH = intracerebral hemorrhage; PROGRESS = Perindopril Protection Against Recurrent Stroke Study; SBP = systolic blood pressure.
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2012, Journal of Neurology, Neurosurgery and Psychiatry
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Original articleCerebral amyloid angiopathy in Chinese: Incidence and significance

Abstract

Cerebral amyloid angiopathy. A critical review

Stroke

Clinicopathologic studies of primary cerebral amyloid angiopathy

Studien zur Pathologie der Hirngefaesse II. Die drusige Entartung der Hirnarterien und Kapillaren. (Eine form senile Gefaesserkrankung)

Z Ges Neurol Psychiat

The incidence of cerebral amyloid angiopathy in Alzheimer's disease

Neurology

Case records of the Massachusetts General Hospital (Case 10-1988)

N Engl J Med

Cerebral amyloid angiopathy: Incidence and complications in the aging brain. I. Cerebral haemorrhage

Stroke

Cerebral amyloid angiopathy: The vascular pathology and complications

J Neuropathol Exp Neurol

Amyloid anglopathy and lobar cerebral haemorrhage

J Neurol Neurosurg Psychiatry

Degenerative cerebral alterations in Chinese aged 65 years or older

Clinical Neuropathology

Cerebral haemorrhage in an urban Chinese population

Funct Neurol

Original article
Cerebral amyloid angiopathy in Chinese: Incidence and significance