Lacunar infarction is independently associated with BNP levels (β = 0.635, p < 0.001), after adjustment for clinical confounding factors [31]; the explanation for this is that the increase in BNP levels may indicate blood stasis, a well-known condition of thrombosis, resulting from the common concurrent drivers of CSVD, such as diabetes mellitus, hypertension, and hyperlipidemia [78]. Here, NPPB is linked to diabetes mellitus.