Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Association between pulse wave velocity and cerebral microbleeds: a systematic review and meta-analysis

Hypertension Research volume 48, pages 314–326 (2025)Cite this article

Abstract

Cerebral microbleeds are associated with events that are among the highest mortality and disability events combined worldwide, as well as with hypertensive vasculopathy. The aim of the present study was to investigate the relationship between a marker of hypertensive vasculopathy, arterial stiffness assessed by pulse wave velocity, and cerebral microbleeds. A systematic review and meta-analysis was performed using PubMed, Scopus, and Web of Science, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Cochrane Collaboration Handbook statements. Data extraction, quality assessment and statistical analyses were performed following pre-established criteria. Twenty-one studies involving 18,436 participants were included. Higher levels of pulse wave velocity were associated with a higher presence of cerebral microbleeds p-OR = 1.26 (95% CI; 1.09–1.45), with considerable heterogeneity; even adjusting for potential confounding variables p-OR = 1.12 (95% CI, 1.05–1.20), with substantial heterogeneity. Only the percentage of women was related to p-OR in the adjusted model. Sensitivity analyses confirmed the robustness of our results. Adjusted models showed publication bias. Higher levels of arterial stiffness are associated with greater presence of cerebral microbleeds. This phenomenon may be caused by damage to the brain under higher blood flow loads, in turn due to age-induced reversal of the stiffness gradient between large and small vessels. As the world’s population is undergoing demographic ageing, our results underline the importance of establishing pulse wave velocity as a cardiovascular marker for early screening and delaying the onset of the characteristic signs of both diseases.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The original contributions outlined in the study are contained within the manuscript or supplementary materials. Further inquiries can be directed to the corresponding author(s).

References

  1. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. 2010;9:689–701.

  2. Li Q, Yang Y, Reis C, Tao T, Li W, Li X, et al. Cerebral small vessel disease. Cell Transpl. 2018;27:1711–22.

    Google Scholar 

  3. Petty GW, Brown RD Jr, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO. Ischemic stroke subtypes: a population-based study of functional outcome, survival, and recurrence. Stroke. 2000;31:1062–8.

    CAS  PubMed  Google Scholar 

  4. Pasi M, Cordonnier C. Clinical relevance of cerebral small vessel diseases. Stroke. 2020;51:47–53.

    PubMed  Google Scholar 

  5. GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795–820.

  6. Makin SD, Turpin S, Dennis MS, Wardlaw JM. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke subtypes. J Neurol Neurosurg Psychiatry. 2013;84:893–900.

    PubMed  Google Scholar 

  7. van der Flier WM, van Straaten EC, Barkhof F, Verdelho A, Madureira S, Pantoni L, et al. Small vessel disease and general cognitive function in nondisabled elderly: the LADIS study. Stroke. 2005;36:2116–20.

  8. Rensma SP, van Sloten TT, Launer LJ, Stehouwer CDA. Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2018;90:164–73.

    PubMed  PubMed Central  Google Scholar 

  9. de Laat KF, Tuladhar AM, van Norden AG, Norris DG, Zwiers MP, de Leeuw FE. Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease. Brain. 2011;134:73–83.

  10. Kim YJ, Kwon HK, Lee JM, Cho H, Kim HJ, Park HK, et al. Gray and white matter changes linking cerebral small vessel disease to gait disturbances. Neurology. 2016;86:1199–207.

  11. van der Holst HM, van Uden IW, Tuladhar AM, de Laat KF, van Norden AG, Norris DG, et al. Cerebral small vessel disease and incident parkinsonism: The RUN DMC study. Neurology. 2015;85:1569–77.

    PubMed  PubMed Central  Google Scholar 

  12. Clancy U, Gilmartin D, Jochems ACC, Knox L, Doubal FN, Wardlaw JM. Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis. Lancet Psychiatry. 2021;8:225–36.

    PubMed  Google Scholar 

  13. Cao QL, Sun Y, Hu H, Wang ZT, Tan L, Yu JT. Alzheimer’s disease neuroimaging initiative. association of cerebral small vessel disease burden with neuropsychiatric symptoms in non-demented elderly: a longitudinal study. J Alzheimers Dis. 2022;89:583–92.

  14. Clancy U, Ramirez J, Chappell FM, Doubal FN, Wardlaw JM, Black SE. Neuropsychiatric symptoms as a sign of small vessel disease progression in cognitive impairment. Cereb Circ Cogn Behav. 2022;3:100041.

    PubMed  PubMed Central  Google Scholar 

  15. Xu X, Chan QL, Hilal S, Goh WK, Ikram MK, Wong TY, et al. Cerebral microbleeds and neuropsychiatric symptoms in an elderly Asian cohort. J Neurol Neurosurg Psychiatry. 2017;88:7–11.

  16. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12:822–38.

    PubMed  PubMed Central  Google Scholar 

  17. Altmann-Schneider I, Trompet S, de Craen AJ, van Es AC, Jukema JW, Stott DJ, et al. Cerebral microbleeds are predictive of mortality in the elderly. Stroke. 2011;42:638–44.

  18. Wilson D, Charidimou A, Ambler G, Fox ZV, Gregoire S, Rayson P, et al. Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis. Neurology. 2016;87:1501–10.

    PubMed  PubMed Central  Google Scholar 

  19. Akoudad S, Wolters FJ, Viswanathan A, de Bruijn RF, van der Lugt A, Hofman A, et al. Association of cerebral microbleeds with cognitive decline and dementia. JAMA Neurol. 2016;73:934–43.

    PubMed  PubMed Central  Google Scholar 

  20. Fazekas F, Kleinert R, Roob G, Kleinert G, Kapeller P, Schmidt R, et al. Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. AJNR Am J Neuroradiol. 1999;20:637-42.

  21. Cordonnier C, Al-Shahi Salman R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain. 2007;130:1988–2003.

  22. Boutouyrie P, Chowienczyk P, Humphrey JD, Mitchell GF. Arterial stiffness and cardiovascular risk in hypertension. Circ Res. 2021;128:864–86.

  23. Laurent S, Boutouyrie P. The structural factor of hypertension: large and small artery alterations. Circ Res. 2015;116:1007–21.

  24. Roob G, Schmidt R, Kapeller P, Lechner A, Hartung HP, Fazekas F. MRI evidence of past cerebral microbleeds in a healthy elderly population. Neurology. 1999;52:991–4.

  25. Xia Y, Wang Y, Yang L, Wang Y, Liang X, Zhao Q, et al. Incident cerebral microbleeds and hypertension defined by the 2017 ACC/AHA Guidelines. Ann Transl Med. 2021;9:314.

    PubMed  PubMed Central  Google Scholar 

  26. Ao DH, Zhai FF, Han F, Zhou LX, Ni J, Yao M, et al. Large vessel disease modifies the relationship between kidney injury and cerebral small vessel disease. Front Neurol. 2018;9:498.

  27. Bae JH, Kim JM, Park KY, Han SH. Association between arterial stiffness and the presence of cerebral small vessel disease markers. Brain Behav. 2021;11:e01935.

    CAS  PubMed  Google Scholar 

  28. Cooper LL, Woodard T, Sigurdsson S, van Buchem MA, Torjesen AA, Inker LA, et al. Cerebrovascular damage mediates relations between aortic stiffness and memory. Hypertension. 2016;67:176–82.

    CAS  PubMed  Google Scholar 

  29. Del Brutto OH, Mera RM, Peñaherrera R, Peñaherrera E, Zambrano M, Costa AF. Arterial stiffness and total cerebral small vessel disease score in community-dwelling older adults: Results from the Atahualpa Project. Vasc Med. 2019;24:6–11.

  30. Gustavsson AM, Stomrud E, Abul-Kasim K, Minthon L, Nilsson PM, Hansson O, et al. Cerebral microbleeds and white matter hyperintensities in cognitively healthy elderly: a cross-sectional cohort study evaluating the effect of arterial stiffness. Cerebrovasc Dis Extra. 2015;5:41–51.

    PubMed  PubMed Central  Google Scholar 

  31. Henskens LH, Kroon AA, van Oostenbrugge RJ, Gronenschild EH, Fuss-Lejeune MM, Hofman PA, et al. Increased aortic pulse wave velocity is associated with silent cerebral small-vessel disease in hypertensive patients. Hypertension. 2008;52:1120–6.

  32. Hughes TM, Wagenknecht LE, Craft S, Mintz A, Heiss G, Palta P, et al. Arterial stiffness and dementia pathology: atherosclerosis risk in communities (ARIC)-PET Study. Neurology. 2018;90:e1248–e1256.

    PubMed  PubMed Central  Google Scholar 

  33. Inkeri J, Tynjälä A, Forsblom C, Liebkind R, Tatlisumak T, Thorn LM, et al. Carotid intima-media thickness and arterial stiffness in relation to cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes. Acta Diabetol. 2021;58:929–37.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Kim YB, Park KY, Chung PW, Kim JM, Moon HS, Youn YC. Brachial-ankle pulse wave velocity is associated with both acute and chronic cerebral small vessel disease. Atherosclerosis. 2016;245:54–9.

  35. Kinjo Y, Ishida A, Kinjo K, Ohya Y. A high normal ankle-brachial index combined with a high pulse wave velocity is associated with cerebral microbleeds. J Hypertens. 2016;34:1586–93.

  36. Ochi N, Tabara Y, Igase M, Nagai T, Kido T, Miki T, et al. Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject. Hypertens Res. 2009;32:255–60.

  37. Palta P, Sharrett AR, Wei J, Meyer ML, Kucharska-Newton A, Power MC, et al. Central arterial stiffness is associated with structural brain damage and poorer cognitive performance: the ARIC study. J Am Heart Assoc. 2019;8:e011045.

    PubMed  PubMed Central  Google Scholar 

  38. Poels MM, Zaccai K, Verwoert GC, Vernooij MW, Hofman A, van der Lugt A, et al. Arterial stiffness and cerebral small vessel disease: the Rotterdam Scan Study. Stroke. 2012;43:2637–42.

    PubMed  Google Scholar 

  39. Riba-Llena I, Jiménez-Balado J, Castañé X, Girona A, López-Rueda A, Mundet X, et al. Arterial stiffness is associated with basal ganglia enlarged perivascular spaces and cerebral small vessel disease load. Stroke. 2018;49:1279–81.

    PubMed  Google Scholar 

  40. Robert C, Ling LH, Tan ESJ, Gyanwali B, Venketasubramanian N, Lim SL, et al. Effects of carotid artery stiffness on cerebral small-vessel disease and cognition. J Am Heart Assoc. 2022;11:e027295.

    PubMed  PubMed Central  Google Scholar 

  41. Romero JR, Himali JJ, Beiser A, Pase MP, Davis-Plourde KL, Parva P, et al. Aortic stiffness and cerebral microbleeds: the Framingham Heart Study. Vasc Med. 2021;26:312–4.

    PubMed  Google Scholar 

  42. Seo WK, Lee JM, Park MH, Park KW, Lee DH. Cerebral microbleeds are independently associated with arterial stiffness in stroke patients. Cerebrovasc Dis. 2008;26:618–23.

    PubMed  Google Scholar 

  43. Song TJ, Kim J, Kim YD, Nam HS, Lee HS, Nam CM, et al. The distribution of cerebral microbleeds determines their association with arterial stiffness in non-cardioembolic acute stroke patients. Eur J Neurol. 2014;21:463–9.

    CAS  PubMed  Google Scholar 

  44. van Elderen SG, Brandts A, Westenberg JJ, van der Grond J, Tamsma JT, van Buchem MA, et al. Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging. Eur Radiol. 2010;20:1132–8.

    PubMed  Google Scholar 

  45. Zhai FF, Ye YC, Chen SY, Ding FM, Han F, Yang XL, et al. Arterial stiffness and cerebral small vessel disease. Front Neurol. 2018;9:723.

    PubMed  PubMed Central  Google Scholar 

  46. Zhang K, Jiang Y, Wang Y, Suo C, Xu K, Zhu Z, et al. Associations of arterial stiffness and carotid atherosclerosis with cerebral small vessel disease in a rural community-based population. J Atheroscler Thromb. 2020;27:922–33.

    PubMed  PubMed Central  Google Scholar 

  47. van Sloten TT, Protogerou AD, Henry RM, Schram MT, Launer LJ, Stehouwer CD. Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2015;53:121–30.

    PubMed  PubMed Central  Google Scholar 

  48. Scott TM, Bhadelia RA, Qiu WQ, Folstein MF, Rosenberg IH. Small vessel cerebrovascular pathology identified by magnetic resonance imaging is prevalent in alzheimer’s disease and mild cognitive impairment: a potential target for intervention. J Alzheimers Dis. 2018;65:293–302.

  49. Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MS, et al. Criteria for evaluation of novel markers of cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:2408–16. Erratum in: Circulation. 2009 Jun 30;119(25):e606. Hong, Yuling [added].

    PubMed  PubMed Central  Google Scholar 

  50. Butlin M, Qasem A. Large artery stiffness assessment using SphygmoCor technology. Pulse (Basel). 2017;4:180–92.

    PubMed  Google Scholar 

  51. Vardoulis O, Papaioannou TG, Stergiopulos N. Validation of a novel and existing algorithms for the estimation of pulse transit time: advancing the accuracy in pulse wave velocity measurement. Am J Physiol Heart Circ Physiol. 2013;304:H1558–67.

    CAS  PubMed  Google Scholar 

  52. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008–12.

    CAS  PubMed  Google Scholar 

  53. Higgins JP, Green S, Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. 2011. Available online at: https://crtha.iums.ac.ir/files/crtha/files/cochrane.pdf. [Cited 10th of April 2024].

  54. National Heart, Lung and Blood Institute. Quality assessment tool for observational cohort and cross‐sectional studies [Internet]. NHLBI, NIH. National Institutes of Health. 2014. Available at: https://www.nhlbi.nih.gov/health‐<underline>topics/study‐quality‐assessment‐tools</underline>. [Cited 10th of April, 2024].

  55. DerSimonian R, Laird N. Meta-analysis in clinical trials revisited. Contemp Clin Trials. 2015;45:139–45.

    PubMed  PubMed Central  Google Scholar 

  56. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statist Med. 2002;21:1539–58.

    Google Scholar 

  57. Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012;30:445–8.

  58. Mori R, Miyata M, Kubozono T, Inadome N, Kawasoe S, Ojima S, et al. Cutoff values of brachial-ankle pulse wave velocity for atherosclerotic risks by age and sex in the Japanese general population. J Atheroscler Thromb. 2023;30:481–90.

    PubMed  Google Scholar 

  59. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Scheuermann BC, Parr SK, Schulze KM, Kunkel ON, Turpin VG, Liang J, et al. Associations of cerebrovascular regulation and arterial stiffness with cerebral small vessel disease: a systematic review and meta-analysis. J Am Heart Assoc. 2023;12:e032616.

    PubMed  PubMed Central  Google Scholar 

  61. Vernooij MW, van der Lugt A, Ikram MA, Wielopolski PA, Niessen WJ, Hofman A, et al. Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology. 2008;70:1208–14.

  62. Ding J, Mitchell GF, Bots ML, Sigurdsson S, Harris TB, Garcia M, et al. Carotid arterial stiffness and risk of incident cerebral microbleeds in older people: the Age, Gene/Environment Susceptibility (AGES)-Reykjavik study. Arterioscler Thromb Vasc Biol. 2015;35:1889–95.

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Yu S, McEniery CM. Central versus peripheral artery stiffening and cardiovascular risk. Arterioscler Thromb Vasc Biol. 2020;40:1028–33.

  64. Mitchell GF, van Buchem MA, Sigurdsson S, Gotal JD, Jonsdottir MK, Kjartansson Ó, et al. Arterial stiffness, pressure and flow pulsatility and brain structure and function: the age, gene/environment susceptibility-Reykjavik study. Brain. 2011;134:3398–407.

    PubMed  PubMed Central  Google Scholar 

  65. Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O’Rourke MF. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation. 1983;68:50–8.

  66. Mitchell GF, Parise H, Benjamin EJ, Larson MG, Keyes MJ, Vita JA, et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. Hypertension. 2004;43:1239–45.

  67. McEniery CM, Yasmin, Hall IR, Qasem A, Wilkinson IB, Cockcroft JR. ACCT Investigators. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol. 2005;46:1753–60.

  68. Mitchell GF. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. J Appl Physiol (1985). 2008;105:1652–60.

    PubMed  PubMed Central  Google Scholar 

  69. Heerkens EH, Izzard AS, Heagerty AM. Integrins, vascular remodeling, and hypertension. Hypertension. 2007;49:1–4.

  70. O’Rourke MF, Safar ME. Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension. 2005;46:200–4.

  71. Lu Y, Kiechl SJ, Wang J, Xu Q, Kiechl S, Pechlaner R. Global distributions of age- and sex-related arterial stiffness: systematic review and meta-analysis of 167 studies with 509,743 participants. EBioMedicine. 2023;92:104619. Global Pulse Wave Velocity Study Group.

    PubMed  PubMed Central  Google Scholar 

  72. Subramanya V, Ambale-Venkatesh B, Ohyama Y, Zhao D, Nwabuo CC, Post WS, et al. Relation of sex hormone levels with prevalent and 10-year change in aortic distensibility assessed by MRI: the multi-ethnic study of atherosclerosis. Am J Hypertens. 2018;31:774–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  73. Zaydun G, Tomiyama H, Hashimoto H, Arai T, Koji Y, Yambe M, et al. Menopause is an independent factor augmenting the age-related increase in arterial stiffness in the early postmenopausal phase. Atherosclerosis. 2006;184:137–42.

    CAS  PubMed  Google Scholar 

  74. Bruno RM, Varbiro S, Pucci G, Nemcsik J, Lønnebakken MT, Kublickiene K, et al. Vascular function in hypertension: does gender dimension matter? J Hum Hypertens. 2023;37:634–43.

    PubMed  Google Scholar 

  75. Lv T, Li C. The study of risk factors and the predict model of cerebral microbleeds. Curr Neurovasc Res. 2023;20:377–89.

    CAS  PubMed  Google Scholar 

  76. Koemans EA, Castello JP, Rasing I, Abramson JR, Voigt S, Perosa V, et al. Sex differences in onset and progression of cerebral amyloid angiopathy. Stroke. 2023;54:306–14.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Yoon CW, Rha JH, Park HK, Park SH, Kwon S, Kim BC, et al. Sex differences in the progression of cerebral microbleeds in patients with concomitant cerebral small vessel disease. Front Neurol. 2022;13:1054624.

    PubMed  PubMed Central  Google Scholar 

  78. Ceylan S, Aeschbacher S, Altermatt A, Sinnecker T, Rodondi N, Blum M, et al. Sex differences of vascular brain lesions in patients with atrial fibrillation. Open Heart. 2022;9:e002033.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. CarVasCare Research Group, Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, 16001, Cuenca, Spain

    Carla Geovanna Lever-Megina, Iván Cavero-Redondo, Alicia Saz-Lara, Nerea Moreno-Herráiz, Elena Rescalvo-Fernández & Iris Otero-Luis

  2. Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000, Talca, Chile

    Iván Cavero-Redondo

Authors
  1. Carla Geovanna Lever-Megina
    View author publications

    Search author on:PubMed Google Scholar

  2. Iván Cavero-Redondo
    View author publications

    Search author on:PubMed Google Scholar

  3. Alicia Saz-Lara
    View author publications

    Search author on:PubMed Google Scholar

  4. Nerea Moreno-Herráiz
    View author publications

    Search author on:PubMed Google Scholar

  5. Elena Rescalvo-Fernández
    View author publications

    Search author on:PubMed Google Scholar

  6. Iris Otero-Luis
    View author publications

    Search author on:PubMed Google Scholar

Contributions

CGL-M and IC-R were responsible for the conception and design of this study, as well as conducting the literature search. AS-L and IO-L provided additional contributions by ensuring the accuracy of the statistical analyses. NM-H and ER-F were involved in data acquisition and the review of editorial errors. All authors participated in the interpretation of the data, critically reviewed the manuscript, approved the final version for publication, and accept full responsibility for all aspects of this article.

Corresponding author

Correspondence to Iván Cavero-Redondo.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lever-Megina, C.G., Cavero-Redondo, I., Saz-Lara, A. et al. Association between pulse wave velocity and cerebral microbleeds: a systematic review and meta-analysis. Hypertens Res 48, 314–326 (2025). https://doi.org/10.1038/s41440-024-01963-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41440-024-01963-6

Keywords

This article is cited by

Search

Advanced search

Quick links