Cardiovascular Risk Factors, Cerebrovascular Disease Burden, and Healthy Brain Aging

Flicker, Leon

doi:10.1016/j.cger.2009.12.005

Cited by 41 publications

(25 citation statements)

References 53 publications

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“…23 Recently, it was suggested that impaired cardiac function can serve as a reversible risk factor for abnormal brain aging. 24 In line with this hypothesis, previous studies showed that patients with heart failure are at an increased risk of developing dementia and structural brain changes.…”

Section: Methods Study Population This Analysis Was Performedmentioning

confidence: 99%

N-terminal pro–brain natriuretic peptide and abnormal brain aging

et al. 2015

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Objective: To investigate the independent association of serum N-terminal fragment of the prohormone natriuretic peptide (NT-proBNP) with structural and functional features of abnormal brain aging in older individuals. Methods:In this cross-sectional study based on the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we included 4,029 older community-dwelling individuals (born 1907 to 1935) with a measured serum level of NT-proBNP. Outcomes included parenchymal brain volumes estimated from brain MRI, cognitive function measured by tests of memory, processing speed, and executive functioning, and presence of depressive symptoms measured using the Geriatric Depression Scale. In a substudy, cardiac output of 857 participants was assessed using cardiac MRI.Results: In multivariate analyses, adjusted for sociodemographic and cardiovascular factors, higher levels of NT-proBNP were independently associated with lower total (p , 0.001), gray matter (p , 0.001), and white matter (p 5 0.001) brain volumes. Likewise, in multivariate analyses, higher levels of NT-proBNP were associated with worse scores in memory (p 5 0.005), processing speed (p 5 0.001), executive functioning (p , 0.001), and more depressive symptoms (p 5 0.002). In the substudy, the associations of higher NT-proBNP with lower brain parenchymal volumes, impaired executive function and processing speed, and higher depressive symptoms were independent of the level of cardiac output.Conclusions: Higher serum levels of NT-proBNP, independent of cardiovascular risk factors and a measure of cardiac function, are linked with alterations in brain structure and function. Roles of natriuretic peptides in the process of brain aging need to be further elucidated. Brain natriuretic peptide (BNP) was first described in 1988 after isolation from porcine brain tissue.1 It was soon found that ventricular myocardium produces BNP, and thereafter, BNP has been regarded as a cardiac hormone.2 Upon release, BNP pro-hormone cleaves into the biologically active BNP hormone and the biologically inactive N-terminal fragment (NTproBNP).3 The main stimulus for BNP and NT-proBNP synthesis is myocardial wall stress, and currently these biomarkers are widely used for diagnosis and prognosis of heart failure. 4 Several reports showed that elevated levels of NT-proBNP not only predict higher risk of ischemic heart disease and cardiac arrhythmias but also cerebrovascular events.5-7 Recent evidence indicates that high NT-proBNP also associates with subclinical brain pathologies such as white matter hyperintensties. 8 The structural and functional integrity of the brain is dependent on an adequate supply of cerebral blood flow. 9

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Section: Methods Study Population This Analysis Was Performedmentioning

confidence: 99%

N-terminal pro–brain natriuretic peptide and abnormal brain aging

et al. 2015

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“…Alguns representam degenerações naturais, tendo como principais exemplos sarcopenia, imunossenescência, diminuição de densidade mineral óssea e aumento da incidência de doenças neurodegenerativas, cardiovasculares e de câncer [2][3][4]. Várias intervenções podem desacelerar o processo de envelhecimento, incluindo a diminuição do tabagismo, as dietas balanceadas, os processos de hidratação e principalmente a prática regular de exercícios físicos [5][6][7][8][9][10].…”

Section: Introductionunclassified

“…Ademais, a dieta oriunda do ocidente, rica em gordura e glicose [8,12], está diretamente associada com DCV [2,9]. As alterações vasculares relacionadas à dilatação dependente do endotélio [11,13] são os principais fatores que interferem no envelhecimento [14].…”

Section: Introductionunclassified

Envelhecimento saudável e atividade física: uma revisão sistemática sobre os efeitos do exercício nas doenças cardiovasculares

Estrela¹,

Bauer

2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. AbStRActAims: To perform a systematic review of randomized controlled trials that assess the benefits of physical exercise (regular or competitive) for the health of the elderly and prevention of cardiovascular diseases. Methods: Publications in PubMed, Web of Science, Library of Congress, Cochrane, and in databases with records of clinical trials between 2005 and 2016, and also in the proceedings of major congresses on cardiovascular diseases in the elderly were investigated using the terms defined in accordance with the "patient, intervention, comparison, and outcome" methodology. The following key words were used: physical effort, exercise, exercise therapy, physical activity, physical fitness, resistance training, cardiovascular disease, C-reactive protein, dyslipidemia, heart failure, cardiac insufficiency, revascularization, cardiac stent and heart transplant. Only randomized clinical trials with individuals aged over 60 years were included. The articles were assessed independently by two reviewers.Results: A total of 3,672 studies were assessed and 24 that met the inclusion criteria were selected. Most of these studies had small sample sizes and showed physical exercise as health-promoting. Only 16 studies reported the relationship of adherence to physical exercise as a preventive factor against cardiovascular diseases. The outcome measures included quality of life, physical ability or fitness status, muscle strength, heart rate, psychological aspects, inflammatory and nutritional markers, and progression of cardiovascular diseases. There is strong evidence that aerobic exercise improves physical fitness, muscle strength, and the quality of life of elderly patients with cardiovascular disease. Conclusions:The benefits of exercise training for elderly patients with cardiovascular disease are well established, supporting the prescription of exercise training for their regular treatments. Interventions that use exercise need to be progressively included in cardiovascular treatment regimens, although the best exercise protocol for patients with cardiovascular disease is not yet fully established.

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“…In the overview, the increasing support for the hypothesis that potentially shared pathophysiological mechanisms are involved is emphasised (10). Several vascular factors may lead to cognitive impairment (11)(12)(13)(14) and dementia (12). Traditionally, Alzheimer's disease has been interpreted as a neurodegenerative disorder without a vascular origin, but recent evidence supports the hypothesis that vascular factors and disorders may be involved in the development of both vascular dementia and Alzheimer's disease (13).…”

Section: Introductionmentioning

confidence: 99%

The association between vascular factors and subjective memory impairment in older people: The HUNT Study, Norway

Langballe

Tambs²,

Saltvedt³

et al. 2012

Nor J Epidemiol

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Objectives: Subjective memory impairment (SMI) is often considered an early sign of dementia. This study investigates the relationship between SMI and dementia-related vascular factors in older people. Method: This study was based on data from 12,255 individuals, 65 years and older, participating in the Nord-Trøndelag health study, third survey 2006-08 (HUNT3). SMI, vascular diseases, exercise, smoking, and alcohol consumption were self-reported. Blood pressure, cholesterol and body mass index (BMI) were clinically measured. SMI were predicted using linear regression analysis. Results: Stroke and heart disease were associated with SMI. High exercise intensity was associated with less SMI. Respondents with high systolic blood pressure (SBP) reported less SMI than those with moderate SBP. In men, low SBP was associated with significantly more SMI compared to those with moderate SBP. In women, moderate alcohol consumption compared to low alcohol consumption was associated with significantly more SMI. Conclusion: SMI was positively associated with stroke and heart disease in this study. For the other investigated vascular factors, we did not find strong relationships with SMI. However, for preventive and treatment purposes, it is noteworthy that high exercise intensity and high systolic blood pressure was associated with less SMI in both genders.

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Cardiovascular Risk Factors, Cerebrovascular Disease Burden, and Healthy Brain Aging

Cited by 41 publications

References 53 publications

N-terminal pro–brain natriuretic peptide and abnormal brain aging

N-terminal pro–brain natriuretic peptide and abnormal brain aging

Envelhecimento saudável e atividade física: uma revisão sistemática sobre os efeitos do exercício nas doenças cardiovasculares

The association between vascular factors and subjective memory impairment in older people: The HUNT Study, Norway

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