Abstract
Cardiovascular health declines with age, increasing the risk of hypertension and elevated heart rate in middle and old age. Here, we used multivariate techniques to investigate the associations between cardiovascular health (diastolic blood pressure, systolic blood pressure, and heart rate) and white matter macrostructure (lesion volume and number) and microstructure (as measured by diffusion-weighted imaging) in the cross-sectional, population-based Cam-CAN cohort (N = 667, aged 18–88). We found that cardiovascular health and age made approximately similar contributions to white matter health and explained up to 56% of variance therein. Lower diastolic blood pressure, higher systolic blood pressure, and higher heart rate were each strongly, and independently, associated with white matter abnormalities on all indices. Body mass and exercise were associated with white matter health, both directly and indirectly via cardiovascular health. These results highlight the importance of cardiovascular risk factors for white matter health across the adult lifespan and suggest that systolic blood pressure, diastolic blood pressure, and heart rate affect white matter health via separate mechanisms.
Highlights
Cardiovascular function changes over the lifespan, with an increased risk of elevated blood pressure and heart rate in middle and old age and a lifetime risk for hypertension of 90% (Vasan et al, 2002)
To assess the relationship between cardiovascular health and white matter microstructure, we modeled mean fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) for 10 tracts of the Johns Hopkins University (JHU) white matter tractography atlas averaged over the hemispheres (Fig. 2)
Estimating latent variables has 2 benefits: first, it reduces measurement error in estimates of cardiovascular health (Little et al, 1999), and second, it allows for examining whether cardiovascular health is best represented as a single factor, which is theoretically plausible, or multiple, partially independent factors
Summary
Cardiovascular function changes over the lifespan, with an increased risk of elevated blood pressure and heart rate in middle and old age and a lifetime risk for hypertension of 90% (Vasan et al, 2002). In turn, are associated with cognitive impairment and the risk of dementia, starting as early as the fifth decade (Knopman et al, 2001; Prins and Scheltens, 2015) This raises the possibility that the high prevalence of cardiovascular ill-health in middle and old age contributes to the decline in cognitive functioning during later life (Kievit et al, 2016; Price et al, 2017; Prins and Scheltens, 2015).
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