Association of arterial structure and function with incident cardiovascular diseases and cognitive decline

Introduction We examined the associations of carotid intima‐media thickness (CIMT), arterial stiffness index (ASI), and pulse pressure (PP) with cerebrovascular disease, cognitive function and decline, and incident cardiovascular diseases (CVD) and dementia in the UK Biobank cohort. Methods The study consisted of 42,711 participants (mean age 64.2 years) with brain magnetic resonance imaging (MRI), vascular assessments, and cognitive testing. Cerebrovascular disease markers included white matter hyperintensities (WMH) and brain volumes. CIMT, ASI, and PP were measured using carotid ultrasound, photoplethysmography, and blood pressure, respectively. General cognitive ability ( g ‐score) was derived from various cognitive tests using principal components analysis (PCA). Results Elevated CIMT, ASI, and PP were associated with increased WMH volume (WMHV). Increased PP was independently associated with poorer numeric memory ( ß = −0.028, p = 0.002), fluid intelligence (IQ) ( ß = −0.060, p < 0.001), and g ‐score ( ß = −0.028, p < 0.001) in cross‐sectional analysis, but not longitudinally. CIMT showed the strongest association with incident CVD and dementia. Discussion CIMT had the most robust associations with WMHV, incident CVD, and dementia, suggesting its utility as an alternative endpoint. Highlights Effects of arterial stiffness on cognition, dementia, and CVD. Structural vascular parameters included CIMT. Functional properties included ASI and PP. CIMT, ASI, and PP were positively associated with WMHV. CIMT had the greatest associations with incident CVD and dementia.