Central arterial stiffness is associated with structural brain damage and poorer cognitive performance: The ARIC study

Priya Palta, A. Richey Sharrett, Jingkai Wei, Michelle L. Meyer, Anna Kucharska-Newton, Melinda C. Power, Jennifer A. Deal, Clifford R. Jack, David Knopman, Jacqueline Wright, Michael Griswold, Hirofumi Tanaka, Thomas H. Mosley, Gerardo Heiss

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

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 diseasesignature 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 3 ; 95% CI, −27.54 to −9.07 cm 3 ), and smaller Alzheimer disease signature region volumes (−1.48 cm 3 ; 95% CI, −2.27 to −0.68 cm 3 ). 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.

Original languageEnglish
Article numbere011045
JournalJournal of the American Heart Association
Volume8
Issue number2
DOIs
StatePublished - Jan 1 2019

Bibliographical note

Funding Information:
The ARIC (Atherosclerosis Risk in Communities) Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I). Neurocognitive data is collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, NINDS, NIA and NIDCD), and with previous brain magnetic resonance imaging examinations funded by R01‐HL70825 from the National Heart, Lung, and Blood Institute. Additional support was provided by the National Institute on Aging for the measures of arterial stiffness and pressure pulsatility (R01AG053938). Dr Palta is supported by grant K99AG052830 from the National Institute on Aging. Dr Deal is supported by grant K01AG054693 from the National Institute on Aging. The views expressed herein are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institute on Aging; the National Institutes of Health; or the US Department of Health and Human Services.

Funding Information:
The ARIC (Atherosclerosis Risk in Communities) Study is carried out asacollaborativestudysupportedbyNationalHeart,Lung,andBlood Institutecontracts(HHSN268201700001I,HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268 201700004I). Neurocognitive data is collected by U01 2U01HL0 96812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01 HL096917 from the NIH (NHLBI, NINDS, NIA and NIDCD), and with previous brain magnetic resonance imaging examinations funded by R01-HL70825 from the National Heart, Lung, and Blood Institute. AdditionalsupportwasprovidedbytheNationalInstituteonAgingfor the measures of arterial stiffness and pressure pulsatility (R01AG053938). Dr Palta is supported by grant K99AG052830 from the National Institute on Aging. Dr Deal is supported by grant K01AG054693 from the National Institute on Aging. The views expressed herein are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institute on Aging; the National Institutes of Health; or the US Department of Health and Human Services.

Publisher Copyright:
© 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Keywords

  • Arterial stiffness
  • Cognition
  • Magnetic resonance imaging
  • Pulse wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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