Kathleen B Miller1, Julie A Fields2, Ronée E Harvey3, Brian D Lahr4, Kent R Bailey4, Michael J Joyner5, Virginia M Miller6,7, Jill N Barnes1. 1. Department of Kinesiology, University of Wisconsin-Madison, Madison, WI. 2. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN. 3. Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN. 4. Department Health Science Research, Mayo Clinic, Rochester, MN. 5. Department of Anesthesiology, Mayo Clinic, Rochester, MN. 6. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN. 7. Department of Surgery, Mayo Clinic, Rochester, MN.
Abstract
BACKGROUND: Studies demonstrate an association between aortic hemodynamics and cognitive function. The impact of pregnancy history on this association is unknown. METHODS: Postmenopausal women (age 59±5 y; years since last pregnancy 35±3) with either a history of preeclampsia (PE; n=34) or with a history of a normotensive pregnancy (NP; n=30) underwent cognitive testing: Letter-Number Sequencing, Digit Span, Trail Making Test, and letter and category fluency. Applanation tonometry was used to derive aortic systolic and diastolic blood pressure and augmentation index. RESULTS: Distribution of cognitive scores and aortic hemodynamic measures were similar between the PE and NP groups. Principal component (PC) analysis was used to reduce the 3 aortic hemodynamic measures and the 5 cognitive variables to single summary indices, each representing a weighted average of their respective constituent variables. Using a multivariable linear model based on these PCs that adjusted for pregnancy history and BMI, the composite index of aortic hemodynamics was associated with the summary cognitive index, whether taking into account a potential interaction with pregnancy history (P=0.035) or not (P=0.026) (interaction P=0.178). Multivariable modeling of individual cognitive tests revealed a differential association for letter fluency by pregnancy history (test for interaction P=0.023); this score correlated with the aortic hemodynamic index in the PE (partial R2=0.20), but not the NP (partial R2=0.00) group. CONCLUSIONS: Elevated aortic hemodynamics may negatively impact cognitive function in postmenopausal women with specific executive functions, such as letter fluency, being impacted more by a pregnancy history of PE.
BACKGROUND: Studies demonstrate an association between aortic hemodynamics and cognitive function. The impact of pregnancy history on this association is unknown. METHODS: Postmenopausal women (age 59±5 y; years since last pregnancy 35±3) with either a history of preeclampsia (PE; n=34) or with a history of a normotensive pregnancy (NP; n=30) underwent cognitive testing: Letter-Number Sequencing, Digit Span, Trail Making Test, and letter and category fluency. Applanation tonometry was used to derive aortic systolic and diastolic blood pressure and augmentation index. RESULTS: Distribution of cognitive scores and aortic hemodynamic measures were similar between the PE and NP groups. Principal component (PC) analysis was used to reduce the 3 aortic hemodynamic measures and the 5 cognitive variables to single summary indices, each representing a weighted average of their respective constituent variables. Using a multivariable linear model based on these PCs that adjusted for pregnancy history and BMI, the composite index of aortic hemodynamics was associated with the summary cognitive index, whether taking into account a potential interaction with pregnancy history (P=0.035) or not (P=0.026) (interaction P=0.178). Multivariable modeling of individual cognitive tests revealed a differential association for letter fluency by pregnancy history (test for interaction P=0.023); this score correlated with the aortic hemodynamic index in the PE (partial R2=0.20), but not the NP (partial R2=0.00) group. CONCLUSIONS: Elevated aortic hemodynamics may negatively impact cognitive function in postmenopausal women with specific executive functions, such as letter fluency, being impacted more by a pregnancy history of PE.
Authors: Brandon G Fico; Kathleen B Miller; Leonardo A Rivera-Rivera; Adam T Corkery; Andrew G Pearson; Nicole A Eisenmann; Anna J Howery; Howard A Rowley; Kevin M Johnson; Sterling C Johnson; Oliver Wieben; Jill N Barnes Journal: Front Cardiovasc Med Date: 2022-02-09