MAPPING THE HEART-BRAIN CONNECTION IN CARDIOVASCULAR DISEASE

Abstract

While it is known that cardiovascular diseases and vascular brain disorders share common medical and lifestyle risk factors, the degree to which having one cardiovascular disease or vascular brain disorder may increase the risk of developing others has not been systematically examined. This study mapped the associated risk between a broad set of cardiovascular diseases and vascular brain disorders to better understand their interconnectedness. We conducted a structured review of the literature to determine and classify the strength of the associated risk between nine cardiovascular diseases and vascular brain disorders. The seven cardiovascular diseases included atrial fibrillation, cardiac arrest, congenital heart disease, coronary artery and vascular disease, heart failure, myocardial infarction, and valvular heart disease (acquired). The two vascular brain disorders included stroke and vascular cognitive impairment. The strength of the associated risk between diseases/conditions was classified as strong, moderate, weak, or no known association based on a review and quality assessment of the existing evidence. All nine conditions were associated with increased risk of at least one other cardiovascular disease or vascular brain disorder. Heart failure and congenital heart disease had the greater number of associations classified as strong – both were strongly associated with increased risk of five other cardiovascular diseases or vascular brain disorders. Six of the seven cardiovascular diseases were associated with increased risk of at least one other cardiovascular disease. Stroke was strongly associated with increased risk of vascular cognitive impairment and vascular cognitive impairment was moderately associated with increased risk of stroke. All seven cardiovascular diseases were associated with increased risk of vascular cognitive impairment. Atrial fibrillation, heart failure, congenital heart disease, and myocardial infarction were each strongly associated with increased risk of stroke. Stroke was strongly associated with increased risk of coronary artery and vascular disease and weakly associated with increased risk of myocardial infarction. This systematic mapping of the associated risk between a broad set of cardiovascular diseases and vascular brain disorders revealed a complex pattern of heart-brain interconnectedness. These connections may have broad impact on healthcare policy, prevention strategy, and systems change in Canada - preventing one disease may prevent many others and reduce the burden on people experiencing these conditions and the healthcare system.