JACC: Relationship between middle-term subclinical atherosclerosis and brain metabolism and cognitive function

Atherosclerosis is the underlying cause of most cardiovascular diseases (CVDs) and the leading cause of death worldwide.
AS is a long-term process that begins early in life.
identifying atherosclerosis in the subclinical stage is an important strategy to improve the prevention effect of CVD level 1.
current clinical practice guidelines suggest that it makes sense to screen for subclinical atherosclerosis in different organ vascular areas in order to intervene earlier.
is one of the leading causes of death and disability worldwide and the most challenging medical problem of the century.
is characterized by a gradual deterioration in cognitive ability, with Alzheimer's disease (AD) being the most common, followed by vascular dementia.
, 50 million people worldwide suffer from dementia.
with the aging of the population, this figure is expected to reach 150 million by 2050.
previous studies have shown that atherosclerosis is associated with cognitive impairment in old age.
Specifically, intracranial atherosclerosis in older adults increases the risk of all cognitive impairments, from mild cognitive impairment to dementia, and cerebral atherosclerosis and small arteriosclerosis are associated with decreased cognitive domain function and an increased risk of AD in old age.
CVD risk factors, including high blood pressure, diabetes, high cholesterol levels, sedentary lifestyles and smoking, can affect glucose intake and metabolism in the brain in older adults, according to a study.
, however, it remains to be known whether atherosclerosis and cognitive decline affect each other and whether they share a common trajectory of development during the long-term asymptomatic phase.
To this end, the team from the Beta Brain Research Center in Barcelona, Spain, led a study of the effects of CVD risk factors and subclinical atherosclerosis on early brain metabolism, with the aim of determining the relationship between brain metabolism and brain blood flow reserve function in middle-term subclinical atherosclerosis individuals.
results were published in the latest issue of the Journal of the American College of Cardiology (JACC).
included 547 asymptomatic middle-age atherosclerosis participants (50±4 years, 82 percent of men) from the PESA study.
all participants received 18F-fluoro deoxygenated glucose (FDG)-positive electron emission fault scan (PET).
used to assess brain metabolism through holistic brain FDG intake and hormone analysis, 3D vascular ultrasound to assess the load of cervical arteries and atherosclerosis plaques.
showed a negative correlation between overall FDG intake and the 30-year Framingham Risk Score (FRS).
the relationship found that this link was mainly mediated by hypertension (d s 0.36).
cervical artery plaque load was also negatively associated with overall brain FDG intake.
further physical analysis showed that the top temporal region (corner area, the upper edge area and the lower temporal back/middle-return) and buckleback were the brain regions most affected by hypertension and cervical artery plaque load.
, these areas are thought to be closely related to the onset of dementia.
, the researchers concluded:
In asymptomatic middle-life atherosclerosis individuals, the risk of CVD was associated with low metabolism in the brain, with high blood pressure the most associated of all interventional CVD risks.
, the findings highlight the need to control cardiovascular risk early in life in order to potentially improve cognitive function in the brain in the future.
: Subclinical Atherosclerosis and Brain Metabolism in Middle-Individuals: The PESA Study. J Am Coll Cardiol. 2021 Feb, 77 (7) 888-898.MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medical and are not authorized to reproduce, and any media, website or individual may not be reproduced, and any media, website or individual shall indicate "Source: Mets Medicine".
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