Matthew P Pase1, Alexa Beiser2, Jayandra J Himali2, Connie Tsao2, Claudia L Satizabal2, Ramachandran S Vasan2, Sudha Seshadri2, Gary F Mitchell2. 1. From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.). matthewpase@gmail.com. 2. From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.).
Abstract
BACKGROUND AND PURPOSE: Aortic stiffening increases the transfers of high pressure and flow pulsatility to small cerebral vessels potentially causing the accumulation of vascular brain injury. Our aim was to investigate the prospective association of aortic stiffness with the risks of incident mild cognitive impairment and dementia. METHODS: We studied 1101 dementia-free Framingham Offspring study participants (mean age, 69±6 years; 54% women). Aortic stiffness was measured as carotid-femoral pulse wave velocity using applanation tonometry and modeled as a linear variable and the top 2 quintiles (>11.4 m/s). Outcomes were the 10-year risk of incident mild cognitive impairment and dementia, including clinically characterized Alzheimer disease. We observed 106, 77, and 59 events of mild cognitive impairment, all-cause dementia, and clinical Alzheimer disease, respectively. RESULTS: After adjustment for age and sex, higher continuous aortic stiffness predicted an increased risk of mild cognitive impairment (hazard ratio, 1.40 [95% confidence interval, 1.13-1.73]), all-cause dementia (hazard ratio, 1.45 [95% confidence interval, 1.13-1.87]), and Alzheimer disease (hazard ratio, 1.41 [95% confidence interval, 1.06-1.87]). In risk factor-adjusted statistical models, aortic stiffness remained a significant predictor of mild cognitive impairment but not incident dementia. In nondiabetic patients, the top 2 quintiles of aortic stiffness were associated with a higher risk of incident all-cause dementia across all statistical models. CONCLUSIONS: Aortic stiffness was an independent predictor of incident mild cognitive impairment in the whole sample and with incident dementia in nondiabetic patients. Our findings suggest aortic stiffness as a potentially modifiable risk factor for clinical cognitive impairment and dementia.
BACKGROUND AND PURPOSE: Aortic stiffening increases the transfers of high pressure and flow pulsatility to small cerebral vessels potentially causing the accumulation of vascular brain injury. Our aim was to investigate the prospective association of aortic stiffness with the risks of incident mild cognitive impairment and dementia. METHODS: We studied 1101 dementia-free Framingham Offspring study participants (mean age, 69±6 years; 54% women). Aortic stiffness was measured as carotid-femoral pulse wave velocity using applanation tonometry and modeled as a linear variable and the top 2 quintiles (>11.4 m/s). Outcomes were the 10-year risk of incident mild cognitive impairment and dementia, including clinically characterized Alzheimer disease. We observed 106, 77, and 59 events of mild cognitive impairment, all-cause dementia, and clinical Alzheimer disease, respectively. RESULTS: After adjustment for age and sex, higher continuous aortic stiffness predicted an increased risk of mild cognitive impairment (hazard ratio, 1.40 [95% confidence interval, 1.13-1.73]), all-cause dementia (hazard ratio, 1.45 [95% confidence interval, 1.13-1.87]), and Alzheimer disease (hazard ratio, 1.41 [95% confidence interval, 1.06-1.87]). In risk factor-adjusted statistical models, aortic stiffness remained a significant predictor of mild cognitive impairment but not incident dementia. In nondiabeticpatients, the top 2 quintiles of aortic stiffness were associated with a higher risk of incident all-cause dementia across all statistical models. CONCLUSIONS: Aortic stiffness was an independent predictor of incident mild cognitive impairment in the whole sample and with incident dementia in nondiabeticpatients. Our findings suggest aortic stiffness as a potentially modifiable risk factor for clinical cognitive impairment and dementia.
Authors: Mariëlle M F Poels; Marieke van Oijen; Francesco U S Mattace-Raso; Albert Hofman; Peter J Koudstaal; Jacqueline C M Witteman; Monique M B Breteler Journal: Stroke Date: 2007-02-01 Impact factor: 7.914
Authors: Matthew P Pase; Jayandra J Himali; Gary F Mitchell; Alexa Beiser; Pauline Maillard; Connie Tsao; Martin G Larson; Charles DeCarli; Ramachandran S Vasan; Sudha Seshadri Journal: Hypertension Date: 2016-01-11 Impact factor: 10.190
Authors: Pauline Maillard; Gary F Mitchell; Jayandra J Himali; Alexa Beiser; Connie W Tsao; Matthew P Pase; Claudia L Satizabal; Ramachandran S Vasan; Sudha Seshadri; Charles DeCarli Journal: Stroke Date: 2016-03-10 Impact factor: 7.914
Authors: Merrill F Elias; Michael A Robbins; Marc M Budge; Walter P Abhayaratna; Gregory A Dore; Penelope K Elias Journal: Hypertension Date: 2009-02-23 Impact factor: 10.190
Authors: Leroy L Cooper; Todd Woodard; Sigurdur Sigurdsson; Mark A van Buchem; Alyssa A Torjesen; Lesley A Inker; Thor Aspelund; Gudny Eiriksdottir; Tamara B Harris; Vilmundur Gudnason; Lenore J Launer; Gary F Mitchell Journal: Hypertension Date: 2015-11-16 Impact factor: 10.190
Authors: Giuseppe Mancia; Robert Fagard; Krzysztof Narkiewicz; Josep Redon; Alberto Zanchetti; Michael Böhm; Thierry Christiaens; Renata Cifkova; Guy De Backer; Anna Dominiczak; Maurizio Galderisi; Diederick E Grobbee; Tiny Jaarsma; Paulus Kirchhof; Sverre E Kjeldsen; Stéphane Laurent; Athanasios J Manolis; Peter M Nilsson; Luis Miguel Ruilope; Roland E Schmieder; Per Anton Sirnes; Peter Sleight; Margus Viigimaa; Bernard Waeber; Faiez Zannad; Josep Redon; Anna Dominiczak; Krzysztof Narkiewicz; Peter M Nilsson; Michel Burnier; Margus Viigimaa; Ettore Ambrosioni; Mark Caufield; Antonio Coca; Michael Hecht Olsen; Roland E Schmieder; Costas Tsioufis; Philippe van de Borne; Jose Luis Zamorano; Stephan Achenbach; Helmut Baumgartner; Jeroen J Bax; Héctor Bueno; Veronica Dean; Christi Deaton; Cetin Erol; Robert Fagard; Roberto Ferrari; David Hasdai; Arno W Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Patrizio Lancellotti; Ales Linhart; Petros Nihoyannopoulos; Massimo F Piepoli; Piotr Ponikowski; Per Anton Sirnes; Juan Luis Tamargo; Michal Tendera; Adam Torbicki; William Wijns; Stephan Windecker; Denis L Clement; Antonio Coca; Thierry C Gillebert; Michal Tendera; Enrico Agabiti Rosei; Ettore Ambrosioni; Stefan D Anker; Johann Bauersachs; Jana Brguljan Hitij; Mark Caulfield; Marc De Buyzere; Sabina De Geest; Geneviève Anne Derumeaux; Serap Erdine; Csaba Farsang; Christian Funck-Brentano; Vjekoslav Gerc; Giuseppe Germano; Stephan Gielen; Herman Haller; Arno W Hoes; Jens Jordan; Thomas Kahan; Michel Komajda; Dragan Lovic; Heiko Mahrholdt; Michael Hecht Olsen; Jan Ostergren; Gianfranco Parati; Joep Perk; Jorge Polonia; Bogdan A Popescu; Zeljko Reiner; Lars Rydén; Yuriy Sirenko; Alice Stanton; Harry Struijker-Boudier; Costas Tsioufis; Philippe van de Borne; Charalambos Vlachopoulos; Massimo Volpe; David A Wood Journal: Eur Heart J Date: 2013-06-14 Impact factor: 29.983
Authors: Alyssa Torjesen; Leroy L Cooper; Jian Rong; Martin G Larson; Naomi M Hamburg; Daniel Levy; Emelia J Benjamin; Ramachandran S Vasan; Gary F Mitchell Journal: Hypertension Date: 2017-04 Impact factor: 10.190
Authors: Ashley E Walker; Elise K Kronquist; Kerrick T Chinen; Kelly D Reihl; Dean Y Li; Lisa A Lesniewski; Anthony J Donato Journal: Exp Physiol Date: 2019-02-03 Impact factor: 2.969
Authors: Athena E Theyers; Benjamin I Goldstein; Arron Ws Metcalfe; Andrew D Robertson; Bradley J MacIntosh Journal: J Cereb Blood Flow Metab Date: 2018-03-21 Impact factor: 6.200
Authors: Kelsey R Thomas; Joel Eppig; Emily C Edmonds; Diane M Jacobs; David J Libon; Rhoda Au; David P Salmon; Mark W Bondi Journal: Neuropsychology Date: 2018-02 Impact factor: 3.295
Authors: Chendi Cui; Akira Sekikawa; Lewis H Kuller; Oscar L Lopez; Anne B Newman; Allison L Kuipers; Rachel H Mackey Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472