Indirect Measures of Arterial Stiffness and Cognitive Performance in Individuals Without Traditional Vascular Risk Factors or Disease

Gutierrez, José; Marshall, Randolph S.; Lazar, Ronald M.

doi:10.1001/jamaneurol.2014.3873

Cited by 19 publications

(20 citation statements)

References 41 publications

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“…Higher ABI values (≧ 1.40) are considered indicative of arterial stiffness, likely due to medial calcification [5,7]. Notably, the prognostic sensitivity of different thresholds for a high ABI also varies [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

et al. 2018

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“…A decreased ABI indicates atherosclerotic changes in large arteries [9] . By contrast, an increased ABI indicates progression of arterial stiffness [13] . Therefore, the ABI is considered a component of arterial stiffness.…”

Section: Outlinementioning

confidence: 99%

“…Cognitive impairment including dementia is also associated with arterial stiffness [8][9][10][11][12] . An ABI >1.30 and increased blood pressure variability are important predictors of cognitive impairment among patients without vascular diseases [13] . Thus, an increased ABI indicates arterial calcification that leads to vessel sclerosis (advanced vessel stiffness).…”

Section: Cognitive Impairmentmentioning

confidence: 99%

Cerebral Small Vessel Disease and Arterial Stiffness: Tsunami Effect in the Brain

Saji

Toba

Sakurai³

2015

Pulse

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Background: Cerebral small vessel diseases, including silent lacunar infarcts, white matter hyperintensities, and microbleeds, pose a risk for cerebrovascular disease, cognitive impairment, and the geriatric syndrome via effects on arterial stiffness. However, the vascular, physiological, and metabolic roles of arterial stiffness in cerebral small vessel diseases remain unclear. Summary: Arterial stiffness can be assessed using various indicators such as the ankle-brachial index, pulse wave velocity, cardio-ankle vascular index, and augmentation index. Arterial stiffness is independently associated with all components of cerebral small vessel disease including silent lacunar infarcts, white matter hyperintensities, and microbleeds, although there are some methodological differences between the various surrogate markers. Evidence of arterial stiffness indicates microvessel arteriosclerosis presenting with vascular endothelial dysfunction. Further, vascular narrowing due to atherosclerosis and vascular stiffness due to lipohyalinosis can accelerate the pulse waves. This hemodynamic stress, pulsatile pressure, or blood pressure variability can cause a 'tsunami effect' towards the cerebral parenchyma and lead to cerebral small vessel disease. Previous studies have shown that silent lacunar infarcts and white matter hyperintensities are strongly associated with arterial stiffness. However, the association between microbleeds and arterial stiffness remains controversial, as there are two vessel mechanisms related to microbleeds: cerebral amyloid angiopathy and hypertensive small vessel disease. Key Messages: Cerebral small vessel disease with as- www.karger.com/pls © 2016 S. Karger AG, Basel sociated arterial stiffness is a risk factor for silent cerebral lesions, stroke, and cognitive impairment. Improvement of the living environment, management of risk factors, and innovation and development of novel drugs that improve arterial stiffness may suppress the progression of cerebral small vessel disease, and may reduce the risk for stroke and dementia.

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“…While some report that antihypertensive medication use is protective against cognitive impairment (69-72), others report higher risk of incident cognitive impairment with antihypertensive drug use, especially diuretics, angiotensin converting enzyme (ACE) inhibitors, and beta blockers (73, 74) as well as a slower decline in cognitive function among patients with dementia (75). Among 302 older adults treated for hypertension, Spinelli et al (76) found those with poor blood pressure control had lower MMSE and verbal fluency scores.…”

Section: Discussionmentioning

confidence: 99%

Sex and Age Differences in the Association of Blood Pressure and Hypertension With Cognitive Function in the Elderly: The Rancho Bernardo Study

Kritz‐Silverstein¹,

Laughlin²,

McEvoy³

et al. 2017

J Prev Alz Dis

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Objectives: This study examines sex and age differences in associations of systolic and diastolic blood pressure (SBP, DBP), pulse pressure and hypertension with cognitive function in a community-dwelling population. Design: Cross-sectional study. Setting: Research clinic visit in 1988-91. Participants: Participants were 693 men and 1022 women aged 50-97 Measurements: Blood pressure was measured and 12 cognitive function tests were administered. Results: Average age was 73.8±9.9 in men and 73.2±9.3 in women; 62.6% of men and 63.4% of women were hypertensive (SBP≥140 mmHg, DBP≥90 mmHg, or antihypertensive medication use). Each 5-unit increment in SBP, DBP, or pulse pressure and categorical hypertension was associated with significantly increased odds of poor verbal fluency performance in men and poor Trails B performance in women, with strongest associations for hypertension (OR=1.97, CI:1.01,3.85 in men; OR=1.51, CI:1.01,2.26 in women). After age stratification, associations remained statistically significant in younger (<80 years ) but not older (≥80 years) participants. Conclusion: Blood pressure as a continuous or categorical variable was associated with poor performance on cognitive function tests, but domains varied by sex and associations were found only in those younger than 80 years. The absent associations in those aged 80 years and older could support the hypothesis that increased blood flow is required to maintain cerebral perfusion with advancing age, or could reflect a survivor effect.

show abstract

Indirect Measures of Arterial Stiffness and Cognitive Performance in Individuals Without Traditional Vascular Risk Factors or Disease

Cited by 19 publications

References 41 publications

Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

Cerebral Small Vessel Disease and Arterial Stiffness: Tsunami Effect in the Brain

Sex and Age Differences in the Association of Blood Pressure and Hypertension With Cognitive Function in the Elderly: The Rancho Bernardo Study

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