Scharf EL, Graff-Radford J, Przybelski SA, et al. - In the Mayo Clinic Study of Aging, a longitudinal population-based study, researchers analyzed the primary midlife and current cardiometabolic risk factors correlated with changes in white matter hyperintensity (WMH) over time. The study sample consisted of individuals with ≥ 2 consecutive WMH assessments on fluid-attenuated inversion recovery-MRIs (n = 554, ≥ 60 years with midlife assessments) and relevant baseline laboratory measures of interest. According to findings, the strongest predictor of progression in WMH was age. In males, baseline hypertension, midlife hypertension, and baseline fasting glucose were predictive of WMH change. The relationships between hypertension and progression of WMH in females were stronger in sensitivity analyses. Baseline serum glucose was related to an increase in WMH, but was not significant in females in the stratified analysis. Other continuous laboratory measures of vascular risk have not been linked to progressive WMH. The investigators concluded that optimal blood pressure should be calculated by prospective clinical studies to reduce stroke and cognitive impairment during aging.