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 Jr. Jack, David S Knopman, Jacqueline Wright, Michael Griswold, Hirofumi Tanaka, Thomas H. Mosley, Gerardo Heiss

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 cm3; 95% CI , -27.54 to -9.07 cm3), and smaller Alzheimer disease signature region volumes (-1.48 cm3; 95% CI , -2.27 to -0.68 cm3). 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 (US)
Pages (from-to)e011045
JournalJournal of the American Heart Association
Volume8
Issue number2
DOIs
StatePublished - Jan 22 2019
Externally publishedYes

Fingerprint

Vascular Stiffness
Pulse Wave Analysis
Thigh
Brain
Blood Pressure
Lacunar Stroke
Alzheimer Disease
Brain Diseases
Cognition
Linear Models
Hemodynamics
Magnetic Resonance Imaging
Apolipoprotein E4
Executive Function
Atherosclerosis
Arterial Pressure
Heart Rate
Logistic Models
Demography
White Matter

Keywords

  • arterial stiffness
  • cognition
  • magnetic resonance imaging
  • pulse wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Central Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance : The ARIC Study. / Palta, Priya; Sharrett, A. Richey; Wei, Jingkai; Meyer, Michelle L.; Kucharska-Newton, Anna; Power, Melinda C.; Deal, Jennifer A.; Jack, Clifford R Jr.; Knopman, David S; Wright, Jacqueline; Griswold, Michael; Tanaka, Hirofumi; Mosley, Thomas H.; Heiss, Gerardo.

In: Journal of the American Heart Association, Vol. 8, No. 2, 22.01.2019, p. e011045.

Research output: Contribution to journalArticle

Palta, P, Sharrett, AR, Wei, J, Meyer, ML, Kucharska-Newton, A, Power, MC, Deal, JA, Jack, CRJ, Knopman, DS, Wright, J, Griswold, M, Tanaka, H, Mosley, TH & Heiss, G 2019, 'Central Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance: The ARIC Study', Journal of the American Heart Association, vol. 8, no. 2, pp. e011045. https://doi.org/10.1161/JAHA.118.011045
Palta, Priya ; Sharrett, A. Richey ; Wei, Jingkai ; Meyer, Michelle L. ; Kucharska-Newton, Anna ; Power, Melinda C. ; Deal, Jennifer A. ; Jack, Clifford R Jr. ; Knopman, David S ; Wright, Jacqueline ; Griswold, Michael ; Tanaka, Hirofumi ; Mosley, Thomas H. ; Heiss, Gerardo. / Central Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance : The ARIC Study. In: Journal of the American Heart Association. 2019 ; Vol. 8, No. 2. pp. e011045.
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T1 - Central Arterial Stiffness Is Associated With Structural Brain Damage and Poorer Cognitive Performance

T2 - The ARIC Study

AU - Palta, Priya

AU - Sharrett, A. Richey

AU - Wei, Jingkai

AU - Meyer, Michelle L.

AU - Kucharska-Newton, Anna

AU - Power, Melinda C.

AU - Deal, Jennifer A.

AU - Jack, Clifford R Jr.

AU - Knopman, David S

AU - Wright, Jacqueline

AU - Griswold, Michael

AU - Tanaka, Hirofumi

AU - Mosley, Thomas H.

AU - Heiss, Gerardo

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N2 - 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 cm3; 95% CI , -27.54 to -9.07 cm3), and smaller Alzheimer disease signature region volumes (-1.48 cm3; 95% CI , -2.27 to -0.68 cm3). 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.

AB - 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 cm3; 95% CI , -27.54 to -9.07 cm3), and smaller Alzheimer disease signature region volumes (-1.48 cm3; 95% CI , -2.27 to -0.68 cm3). 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.

KW - arterial stiffness

KW - cognition

KW - magnetic resonance imaging

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