Racial ethnic variations in the cardiometabolic determinants and blood pressure of white matter hyperintensities among females—The HABS‐HD Study

Abstract INTRODUCTION White matter hyperintensity volume (WMH), markers of cerebral small vessel disease, are disproportionately prevalent among Black/African American and Hispanic individuals. While cardiometabolic risk factors contribute to WMHs, their association across racial ethnic groups among females remains unclear. This study examines associations among cardiometabolic risk factors, blood pressure, and WMH volume in non‐Hispanic White (NHW), non‐Hispanic Black (NHB), and Hispanic females. METHODS Using the Health and Aging Brain Study Health Disparities (HABS‐HD) cross‐sectional visit 1 data ( N  = 2209), we assessed cardiometabolic risk factors and blood pressure measures in relation to WMH volume via multivariable linear regression models stratified by race/ethnicity. RESULTS Hypertension was associated with increased WMH volume in NHW females. Diabetes was a significant predictor in Hispanics. Systolic blood pressure and mean arterial pressure were associated with WMH volume in NHB. DISCUSSION Findings highlight racial differences in cardiometabolic contributions to WMH burden, emphasizing the need for tailored prevention strategies in racially and ethnically diverse female populations. Highlights Overall, there was a main effect of hypertension; however, in stratified analyses hypertension was significantly was associated with greater white matter hyperintensity (WMH) burden in non‐Hispanic White females. Non‐Hispanic Black females presented with a worse cardiometabolic profile, but this composite was not associated with WMH burden. There was a positive association with the risk composite in non‐Hispanic White and Hispanic females. Systolic blood pressure and mean arterial pressure were associated with greater WMH in non‐Hispanic Black females, highlighting differential blood pressure contributions to WMH burden.