Key result
Improving CV health from midlife to late-life is linked to ~7% lower odds of microbleeds.
Why the study?
Data on the association of cardiovascular health across midlife and late-life with late-life cerebral vascular disease are lacking.
Does improving cardiovascular health from midlife to late-life reduce the prevalence of MRI markers of cerebral vascular disease in late-life?
Cohort (n=1,638)
Does improving cardiovascular health from midlife to late-life reduce the prevalence of MRI markers of cerebral vascular disease in late-life?
Odds Ratio: 0.93 (95% CI 0.9–0.97)
Improving cardiovascular health from midlife to late-life is associated with a lower prevalence of MRI markers of cerebral vascular disease.
May support sustained CVH improvement to lessen late-life cerebral SVD markers; hypothesis-generating and requires prospective trials.
BACKGROUND: Cardiovascular health may be used for prevention of cerebral vascular disease; however, data on the association of cardiovascular health across midlife and late-life with late-life cerebral vascular disease are lacking. Our aim was to examine whether midlife or late-life cardiovascular health as well as changes of cardiovascular health within midlife and between midlife and late-life were associated with prevalence of magnetic resonance imaging markers of cerebral vascular disease at late-life. METHODS: Prospective cohort study including 1638 participants from the Atherosclerosis Risk in Communities Study who took part in 2 visits at midlife (mean ages, 53 and 59 years), and a late-life visit (mean age, 76 years). A cardiovascular health Life's Simple 7 score (range, 0-12/0-14, depending on diet availability) including 6 out of 7 items was calculated at each visit, with weight assigned to each item as poor (0), intermediate (1), or ideal (2). Participants underwent 3T brain magnetic resonance imaging scans in late-life visit. Outcomes were white matter hyperintensity volume, microbleeds, and lacunar, subcortical, and cortical infarcts at late-life. Linear and logistic regression models were used to assess the associations of cardiovascular health in midlife and late-life, and improvement of cardiovascular health within midlife, and from midlife to late-life with magnetic resonance imaging markers of cerebral vascular disease, adjusting for potential confounders. RESULTS: A higher cardiovascular health in midlife, improvement of cardiovascular health within midlife, higher cardiovascular health at late-life, and improvement of cardiovascular health from midlife to late-life were associated with a lower prevalence of cerebral vascular disease markers. For example, improvement in cardiovascular health (per point) from midlife to late-life was associated with smaller white matter hyperintensity volume (β, -0.07 [95% CI, -0.10 to -0.04]) and lower odds of microbleeds (odds ratio, 0.93 [0.90-0.97]), lacunar (odds ratio, 0.93 [0.89-0.97]), subcortical (odds ratio, 0.93 [0.89-0.97]), and cortical infarcts (odds ratio, 0.92 [0.87-0.97]). CONCLUSIONS: Improving cardiovascular health within midlife and from midlife to late-life may prevent development of cerebral vascular disease.
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Sedaghat et al. (2023) conducted a cohort in Cerebral vascular disease (n=1,638). Improvement in cardiovascular health (Life's Simple 7 score) vs. Lower cardiovascular health or no improvement was evaluated on Microbleeds at late-life (OR 0.93, 95% CI 0.90-0.97). Improvement in cardiovascular health from midlife to late-life was associated with lower odds of microbleeds (OR 0.93; 95% CI 0.90-0.97) and smaller white matter hyperintensity volume.
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