Markers of endothelial dysfunction and cerebral blood flow in older adults.

We investigated the association of 2 markers of endothelial dysfunction, tissue plasminogen activator (t-PA) and Von Willebrand factor (VWF), with cerebral blood flow (CBF) in 541 older participants at high risk for cardiovascular disease. Serum levels of t-PA and VWF were measured at baseline. Participants underwent 2 successive brain magnetic resonance imaging scans, first at baseline and the then after a mean follow-up of 33 months. Total CBF was determined in each scan and also standardized for brain parenchymal volume. At baseline, higher t-PA was associated with lower CBF (p = 0.034). In the longitudinal analysis, higher levels of VWF were associated with a steeper decline in CBF (p = 0.043). There was no association between t-PA and decrease in CBF. These associations were independent of sociodemographic and cardiovascular factors. In conclusion, elevated markers of endothelial dysfunction are associated with lower CBF in older adults at risk for cardiovascular disease.