Cardiovascular health in young adulthood and structural brain MRI in midlife: The CARDIA study

Michael P. Bancks, Norrina B. Allen, Prachi Dubey, Lenore J. Launer, Donald M. Lloyd-Jones, Jared P. Reis, Stephen Sidney, Yuichiro Yano, Pamela J. Schreiner

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Objective: To examine the association between the American Heart Association (AHA) Life's Simple 7 (LS7) metric and brain structure. Methods: We determined cardiovascular health (CVH) according to the AHA LS7, assigning 0, 1, or 2 points for meeting poor, intermediate, or ideal criteria for the 7 components (range 0-14) at baseline (aged 18-30 years in 1985-1986) and year 25 follow-up examination for 518 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) brain MRI substudy. Visit-based CVH score and average score was assessed in relation to percent of intracranial volume of normal tissue of the whole brain, gray matter, and white matter, and abnormal tissue volume of white matter at year 25 using multivariable linear, logistic, and quantile regression, after adjustment for age, sex, race, field center, educational attainment, and alcohol consumption. Results: Mean percentage of whole brain volume, normal gray matter, and normal white matter was 81.3% (±2.5), 42.9% (±2.0), and 38.4% (±2.0). Greater CVH score at baseline (per each additional point at year 0: 0.1%, 95% confidence limits 0.01-0.3; p < 0.05) and average CVH score were associated with greater percentage of whole brain volume (per each additional point in average score: 0.2%, 95% confidence limits 0.04-0.3; p < 0.05). Visit-based or average CVH score was not significantly associated with normal gray or white matter volume or abnormal white matter volume. Conclusions: Maintaining ideal levels of cardiovascular health, determined by the LS7, in young adulthood is associated with greater whole brain volume in middle age but not regional differences in structure.

Original languageEnglish (US)
Pages (from-to)680-686
Number of pages7
Issue number7
StatePublished - Aug 15 2017

Bibliographical note

Funding Information:
M.P.B. was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the NIH under award numbers T32HL007779 and T32HL069771 to conduct the current work. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201300025C and HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005).

Publisher Copyright:
© 2017 American Academy of Neurology.


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