Association of ideal cardiovascular health with vascular brain injury and incident dementia
Open accessAbstract
Background and Purpose—: The American Heart Association developed the ideal cardiovascular health (CVH) index as a simple tool to promote CVH; yet, its association with brain atrophy and dementia remains unexamined. Methods—: Our aim was to investigate the prospective association of ideal CVH with vascular brain injury, including the 10-year risks of incident stroke and dementia, as well as cognitive decline and brain atrophy on magnetic resonance imaging, measured for ≈7 years. We studied 2750 stroke- and dementia-free Framingham Heart Study Offspring cohort participants (mean age, 62±9 years; 45% men). Ideal CVH was quantified on a 7-point scale with 1 point awarded for each of the following: nonsmoking status, ideal body mass index, regular physical activity, healthy diet, as well as optimum blood pressure, cholesterol, and fasting blood glucose. Both recent (baseline) and remote (6.9 years earlier) ideal CVH scores were examined. Results—: Recent ideal CVH was associated with stroke (hazard ratio, 0.80; 95% confidence interval, 0.67–0.95), vascular dementia (hazard ratio, 0.49; 95% confidence interval, 0.30–0.81), frontal brain atrophy ( P =0.003), and cognitive decline on tasks measuring visual memory and reasoning ( P <0.05). In addition to predicting stroke, vascular dementia, whole-brain atrophy, and cognitive decline, remote ideal CVH was associated with the incidence of all-cause dementia (hazard ratio, 0.80; 95% confidence interval, 0.67–0.97) and Alzheimer disease (hazard ratio, 0.79; 95% confidence interval, 0.64–0.98). Conclusions—: Adherence to the American Heart Association’s ideal CVH factors and behaviors, particularly in midlife, may protect against cerebrovascular disease and dementia.
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In the same cohort, late-midlife people with ideal cardiovascular parameters had lower 10-year risk of all-cause dementia, vascular dementia, and clinically diagnosed Alzheimer's disease than people with at least one risk factor.
“Those with ideal cardiovascular parameters had a lower 10-year risk of all-cause dementia (HR 0·8, 95% CI 0·1–1·0), vascular dementia (0·5, 0·3–0·8) and clinically diagnosed Alzheimer's disease (0·8, 0·6–1·0).”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [75]
The Results (‘Ideal-CVH and the 10-year risk of stroke and dementia’; page unavailable) associate higher remote, midlife Ideal-CVH scores with lower 10-year risks of all-cause dementia, vascular dementia, and clinically apparent Alzheimer’s disease. The Methods (‘Primary exposure’; page unavailable) define Ideal-CVH as a seven-point score, so the reported hazard ratios do not compare people with all ideal parameters against people with at least one risk factor. The Abstract Results also give the all-cause dementia HR of 0.80 a 95% CI of 0.67–0.97, not 0.1–1.0. (LLM, conf=0.90)
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Atherosclerosis, its risk factors, and cognitive impairment in older adults.
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Self-citationMultiple markers contribute to risk of progression from normal to mild cognitive impairment
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Hearing Loss, Brain Structure, Cognition, and Dementia Risk in the Framingham Heart Study
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Investigating the associations between childhood trauma and cardiovascular health in midlife
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Self-citationShort Sleep Duration and Hypertension: A Double Hit for the Brain
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Self-citationCirculating adipokines and MRI markers of brain aging in middle-aged adults from the community
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Self-citationMRI in older patients—A focused review
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Data from Digital Health Devices Informs Ideal Cardiovascular Health
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- Authors
- Pase, M. P., Beiser, A., Enserro, D., Xanthakis, V., Aparicio, H., Satizabal, C. L., Himali, J. J., Kase, C. S., Vasan, R. S., DeCarli, C., & Seshadri, S.
- Affiliations
- Boston University (US)
- From the Department of Neurology (M.P.P., A.B., H.A., C.L.S., J.J.H., S.S.), and Section of Preventive Medicine, Department of Medicine (D.E., V.X., R.S.V.), Boston University School of Medicine and Framingham Heart Study (M.P.P., A.B., D.E., V.X., H.A., C.L.S., J.J.H., R.S.V., S.S.), Boston, MA; Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.);...
- ORCID
- Venue
- Stroke
- Published
- 2016-05
- Volume
- 47
- Issue
- 5
- Pages
- 1201-1206
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC5006676
- OpenAlex
- W2337772917
- Cited by
- 137
- References
- 32
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 19 · 2023: 13 · 2022: 23 · 2021: 15 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 14 · 2016: 2
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Swinburne figshare (Swinburne University of Technology) (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Health and Medical Research Council (1089698)
- National Institute on Aging (P30AG010129, U01AG049505, R01AG047645, R01AG054076, R01AG049607, R01AG033193, R01AG008122)
- National Heart, Lung, and Blood Institute (HHSN268201500001I, HHSN268201500001C, N01-HC-025195)
- National Institute of Neurological Disorders and Stroke (L30 NS093634, R01NS017950)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- ideal cardiovascular health, vascular brain injury, dementia, brain atrophy, cognitive decline, Alzheimer's disease, vascular dementia, cardiovascular risk factors, midlife
- MeSH terms
- Aged, American Heart Association, Atrophy, Cerebrovascular Disorders, Dementia, Female, Health Status Indicators, Humans, Male, Massachusetts, Middle Aged, Risk, United States, Cohort Studies, Incidence, Guideline Adherence, Cerebrovascular Trauma, Stroke
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