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Central Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance: The ARIC Study.

TitleCentral Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance: The ARIC Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsPalta P, Sharrett ARichey, Wei J, Meyer ML, Kucharska-Newton AMaria, Power MC, Deal JA, Jack CR, Knopman D, Wright J, Griswold M, Tanaka H, Mosley TH
Secondary AuthorsHeiss G
JournalJ Am Heart Assoc
Volume8
Issue2
Paginatione011045
Date Published2019 01 22
ISSN2047-9980
KeywordsAged, Aged, 80 and over, Blood Pressure, Brain, Brain Injuries, Cognition, Cognitive Dysfunction, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pulse Wave Analysis, Retrospective Studies, Vascular Stiffness
Abstract

Background Central arterial stiffening and increased pulsatility, with consequent cerebral hypoperfusion, may result in structural brain damage and cognitive impairment. Methods and Results We analyzed a cross-sectional sample of ARIC - NCS (Atherosclerosis Risk in Communities-Neurocognitive Study) participants (aged 67-90 years, 60% women) with measures of cognition (n=3703) and brain magnetic resonance imaging (n=1255). Central arterial hemodynamics were assessed as carotid-femoral pulse wave velocity and pressure pulsatility (central pulse pressure). We derived factor scores for cognitive domains. Brain magnetic resonance imaging using 3-Tesla scanners quantified lacunar infarcts; cerebral microbleeds; and volumes of white matter hyperintensities, total brain, and the Alzheimer disease signature region. We used logistic regression, adjusted for demographics, apolipoprotein E ɛ4, heart rate, mean arterial pressure, and select cardiovascular risk factors, to estimate the odds of lacunar infarcts or cerebral microbleeds. Linear regression, additionally adjusted for intracranial volume, estimated the difference in log-transformed volumes of white matter hyperintensities , total brain, and the Alzheimer disease signature region. We estimated the mean difference in cognitive factor scores across quartiles of carotid-femoral pulse wave velocity or central pulse pressure using linear regression. Compared with participants in the lowest carotid-femoral pulse wave velocity quartile, participants in the highest quartile of carotid-femoral pulse wave velocity had a greater burden of white matter hyperintensities ( P=0.007 for trend), smaller total brain volumes (-18.30 cm; 95% CI , -27.54 to -9.07 cm), and smaller Alzheimer disease signature region volumes (-1.48 cm; 95% CI , -2.27 to -0.68 cm). These participants also had lower scores in executive function/processing speed (β=-0.04 z score; 95% CI , -0.07 to -0.01 z score) and general cognition (β=-0.09 z score; 95% CI , -0.15 to -0.03 z score). Similar results were observed for central pulse pressure . Conclusions Central arterial hemodynamics were associated with structural brain damage and poorer cognitive performance among older adults.

DOI10.1161/JAHA.118.011045
Alternate JournalJ Am Heart Assoc
PubMed ID30646799
PubMed Central IDPMC6497348
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
R01 AG053938 / AG / NIA NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States
K01 AG054693 / AG / NIA NIH HHS / United States
K99 AG052830 / AG / NIA NIH HHS / United States