Alexander C Razavi1,2, Camilo Fernandez1,2, Jiang He1,2, Tanika N Kelly1, Marie Krousel-Wood1,2, Seamus P Whelton3, Owen T Carmichael4, Lydia A Bazzano1,2. 1. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. 2. Department of Medicine, Tulane University School of Medicine, New Orleans, LA. 3. The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD. 4. Pennington Biomedical Research Center, Baton Rouge, LA.
Abstract
BACKGROUND: Elevated cardiovascular disease risk factor burden is a recognized contributor to poorer cognitive function; however, the physiological mechanisms underlying this association are not well understood. We sought to assess the potential mediation effect of left ventricular (LV) remodeling on the association between lifetime systolic blood pressure and cognitive function in a community-based cohort of middle-aged adults. METHODS: Nine hundred sixty participants of the Bogalusa Heart Study (59.2% women, 33.8% black, aged 48.4±5.1 years) received 2-dimensional echocardiography to quantify relative wall thickness, LV mass, and diastolic and systolic LV function; and a standardized neurocognitive battery to assess memory, executive functioning, and language processing. Multivariable linear regression assessed the association of cardiac structure and function with a global composite cognitive function score, adjusting for traditional cardiovascular disease risk factors. Mediation analysis assessed the effect of LV mass index on the association between lifetime systolic blood pressure burden and cognitive function. RESULTS: There were 233 (24.3%) and 136 (14.2%) individuals with concentric LV remodeling and concentric LV hypertrophy, respectively. Each g/m2.7 increment in LV mass index was associated with a 0.03 standardized unit decrement in global cognitive function (P=0.03). Individuals with concentric LV remodeling and isolated diastolic dysfunction had the poorest cognitive function, and a greater ratio between early mitral inflow velocity and early diastolic mitral annular velocity (E/e') was associated with poorer cognitive function, even after adjustment for LV mass index (B=-0.12; P=0.03). A total of 18.8% of the association between lifetime systolic blood pressure burden and midlife cognitive function was accounted for by LV mass index. CONCLUSIONS: Cardiac remodeling partially mediates the association between lifespan systolic blood pressure burden and adult cognition in individuals without dementia or clinical cardiovascular disease. Slowing or reversing the progression of cardiac remodeling in middle-age may be a novel therapeutic approach to prevent cognitive decline.
BACKGROUND: Elevated cardiovascular disease risk factor burden is a recognized contributor to poorer cognitive function; however, the physiological mechanisms underlying this association are not well understood. We sought to assess the potential mediation effect of left ventricular (LV) remodeling on the association between lifetime systolic blood pressure and cognitive function in a community-based cohort of middle-aged adults. METHODS: Nine hundred sixty participants of the Bogalusa Heart Study (59.2% women, 33.8% black, aged 48.4±5.1 years) received 2-dimensional echocardiography to quantify relative wall thickness, LV mass, and diastolic and systolic LV function; and a standardized neurocognitive battery to assess memory, executive functioning, and language processing. Multivariable linear regression assessed the association of cardiac structure and function with a global composite cognitive function score, adjusting for traditional cardiovascular disease risk factors. Mediation analysis assessed the effect of LV mass index on the association between lifetime systolic blood pressure burden and cognitive function. RESULTS: There were 233 (24.3%) and 136 (14.2%) individuals with concentric LV remodeling and concentric LV hypertrophy, respectively. Each g/m2.7 increment in LV mass index was associated with a 0.03 standardized unit decrement in global cognitive function (P=0.03). Individuals with concentric LV remodeling and isolated diastolic dysfunction had the poorest cognitive function, and a greater ratio between early mitral inflow velocity and early diastolic mitral annular velocity (E/e') was associated with poorer cognitive function, even after adjustment for LV mass index (B=-0.12; P=0.03). A total of 18.8% of the association between lifetime systolic blood pressure burden and midlife cognitive function was accounted for by LV mass index. CONCLUSIONS: Cardiac remodeling partially mediates the association between lifespan systolic blood pressure burden and adult cognition in individuals without dementia or clinical cardiovascular disease. Slowing or reversing the progression of cardiac remodeling in middle-age may be a novel therapeutic approach to prevent cognitive decline.
Authors: Osvaldo P Almeida; Griselda J Garrido; Christopher Beer; Nicola T Lautenschlager; Leonard Arnolda; Leon Flicker Journal: Eur Heart J Date: 2012-01-31 Impact factor: 29.983
Authors: Rebecca F Gottesman; Andrea L C Schneider; Marilyn Albert; Alvaro Alonso; Karen Bandeen-Roche; Laura Coker; Josef Coresh; David Knopman; Melinda C Power; Andreea Rawlings; A Richey Sharrett; Lisa M Wruck; Thomas H Mosley Journal: JAMA Neurol Date: 2014-10 Impact factor: 18.302
Authors: Giovanni de Simone; Jorge R Kizer; Marcello Chinali; Mary J Roman; Jonathan N Bella; Lyle G Best; Elisa T Lee; Richard B Devereux Journal: Am J Hypertens Date: 2005-02 Impact factor: 2.689
Authors: Chloe M Park; Emily D Williams; Nish Chaturvedi; Therese Tillin; Robert J Stewart; Marcus Richards; Dean Shibata; Jamil Mayet; Alun D Hughes Journal: J Am Heart Assoc Date: 2017-04-18 Impact factor: 5.501
Authors: Gregory A Roth; Catherine O Johnson; Kalkidan Hassen Abate; Foad Abd-Allah; Muktar Ahmed; Khurshid Alam; Tahiya Alam; Nelson Alvis-Guzman; Hossein Ansari; Johan Ärnlöv; Tesfay Mehari Atey; Ashish Awasthi; Tadesse Awoke; Aleksandra Barac; Till Bärnighausen; Neeraj Bedi; Derrick Bennett; Isabela Bensenor; Sibhatu Biadgilign; Carlos Castañeda-Orjuela; Ferrán Catalá-López; Kairat Davletov; Samath Dharmaratne; Eric L Ding; Manisha Dubey; Emerito Jose Aquino Faraon; Talha Farid; Maryam S Farvid; Valery Feigin; João Fernandes; Joseph Frostad; Alemseged Gebru; Johanna M Geleijnse; Philimon Nyakauru Gona; Max Griswold; Gessessew Bugssa Hailu; Graeme J Hankey; Hamid Yimam Hassen; Rasmus Havmoeller; Simon Hay; Susan R Heckbert; Caleb Mackay Salpeter Irvine; Spencer Lewis James; Dube Jara; Amir Kasaeian; Abdur Rahman Khan; Sahil Khera; Abdullah T Khoja; Jagdish Khubchandani; Daniel Kim; Dhaval Kolte; Dharmesh Lal; Anders Larsson; Shai Linn; Paulo A Lotufo; Hassan Magdy Abd El Razek; Mohsen Mazidi; Toni Meier; Walter Mendoza; George A Mensah; Atte Meretoja; Haftay Berhane Mezgebe; Erkin Mirrakhimov; Shafiu Mohammed; Andrew Edward Moran; Grant Nguyen; Minh Nguyen; Kanyin Liane Ong; Mayowa Owolabi; Martin Pletcher; Farshad Pourmalek; Caroline A Purcell; Mostafa Qorbani; Mahfuzar Rahman; Rajesh Kumar Rai; Usha Ram; Marissa Bettay Reitsma; Andre M N Renzaho; Maria Jesus Rios-Blancas; Saeid Safiri; Joshua A Salomon; Benn Sartorius; Sadaf Ghajarieh Sepanlou; Masood Ali Shaikh; Diego Silva; Saverio Stranges; Rafael Tabarés-Seisdedos; Niguse Tadele Atnafu; J S Thakur; Roman Topor-Madry; Thomas Truelsen; E Murat Tuzcu; Stefanos Tyrovolas; Kingsley Nnanna Ukwaja; Tommi Vasankari; Vasiliy Vlassov; Stein Emil Vollset; Tolassa Wakayo; Robert Weintraub; Charles Wolfe; Abdulhalik Workicho; Gelin Xu; Simon Yadgir; Yuichiro Yano; Paul Yip; Naohiro Yonemoto; Mustafa Younis; Chuanhua Yu; Zoubida Zaidi; Maysaa El Sayed Zaki; Ben Zipkin; Ashkan Afshin; Emmanuela Gakidou; Stephen S Lim; Ali H Mokdad; Mohsen Naghavi; Theo Vos; Christopher J L Murray Journal: JAMA Cardiol Date: 2018-05-01 Impact factor: 14.676
Authors: Masayo Koide; Osama F Harraz; Fabrice Dabertrand; Thomas A Longden; Hannah R Ferris; George C Wellman; David C Hill-Eubanks; Adam S Greenstein; Mark T Nelson Journal: J Clin Invest Date: 2021-09-15 Impact factor: 14.808