Abstract P304: High Cardiovascular Health Metrics Score Predicts Slower Cognitive Performance Decline in Coronary Patients

Abstract

Introduction: In 2010, the American Heart Association introduced a metric defining the concept of ideal cardiovascular health (CVH) metrics as part of its 2020 Impact Goals definition designed for the health general population. Several studies have demonstrated that a higher number of ideal CVH metrics were associated with a lower rate of cardiovascular events, stroke and all-cause mortality. Hypothesis: We hypothesized that a modified cardiovascular health (CVH) metrics score among patients with CHD may be associated with the change in cognitive functions two decades later in patients. Methods: CVH metrics were assessed in a subgroup of men, who had previously participated in a secondary prevention trial and two successive examinations of cognitive function (N=200, mean age at baseline 57.3±6.3 yrs.). A CVH metrics score at baseline was calculated including 3 health parameters, glucose, LDL-cholesterol, blood-pressure; and 4 health behaviors, smoking, obesity, physical-activity and adherence to Mediterranean diet. We scored each of these CVH metrics into best (2 points), intermediate (1 point), and poor levels (0 points). Cognitive performance was evaluated 14.7±1.9 and 19.9±1.0 years after entry to the trial. Cognitive function was assessed using the NeuroTrax Computerized Cognitive Battery. Linear mixed model was used to assess change in cognitive functions between T1 and T2 cognitive evaluations. Results: Among the 200 patients, 68 (34.0%) had less than 7 (bottom group), 85 (42.5%) had 8-9 (middle group) and 47 (23.5%) had at least 10 CVH metrics points (top group). After adjustments, the top group of CVH score vs. others was associated with slower decline in overall cognitive performance composite z-score [0.23±0.09; p=0.009] and on tests of executive and visual spatial functions [0.23±0.11; p=0.047 and 0.49±0.17; p=0.004, respectively]. A 3 point-Increment in the health behaviors component was related to a slower decline in visuospatial functions [0.325±0.12; p=0.01]. Conclusion: an inverse association was observed between the score of best CVH metrics and cognitive decline among men with pre-existing CHD.