Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life

Sanaz Sedaghat; Yuekai Ji; Jean Philippe Empana; Timothy M. Hughes; Thomas H. Mosley; Rebecca F. Gottesman; Michael Griswold; Clifford R. Jack; Pamela L. Lutsey; Thomas T. Van Sloten

doi:10.1161/strokeaha.122.041374

Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life

Sanaz Sedaghat, Yuekai Ji, Jean Philippe Empana, Timothy M. Hughes, Thomas H. Mosley, Rebecca F. Gottesman, Michael Griswold, Clifford R. Jack, Pamela L. Lutsey, Thomas T. Van Sloten

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Pages (from-to)	1280-1288
Number of pages	9
Journal	Stroke
Volume	54
Issue number	5
DOIs	https://doi.org/10.1161/strokeaha.122.041374
State	Published - May 1 2023

Bibliographical note

Funding Information:
The ARIC study (Atherosclerosis Risk in Communities) is performed as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, 75N92022D00005). The ARIC Neurocognitive Study is supported by U01HL096812, U01HL096814, U01HL096899, U01HL096902, U01HL096917 from the National Institutes of Health (National Heart, Lung, and Blood Institute [NHLBI], National Institute of Neurological Disorders and Stroke, National Institute on Aging, and National Institute on Deafness and Other Communication Disorders) and with previous brain magnetic resonance imaging examinations funded by R01-HL70825 from the NHLBI. Dr Sedaghat is supported by a McKnight Clinical Translational Research Scholarship in Cognitive Aging and Age-Related Memory Loss. Dr van Sloten is supported by a VENI research grant (916.19.074) from The Netherlands Organization for Scientific Research and a Dutch Heart Foundation research grant (2018T025). Dr Lutsey is supported by K24 HL159246. Dr Gottesman is supported by the Intramural Research Program of the National Institute of Neurological Disorders and Stroke.

Funding Information:
Dr Mosley received grants from National Institutes of Health Clinical Center. Dr Gottesman received compensation from American Academy of Neurology for other services. The other authors report no conflicts.

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.

Keywords

atherosclerosis
brain
lacunar stroke
magnetic resonance imaging
prevalence

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

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10.1161/strokeaha.122.041374

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@article{d245efe3b6e84d57b1266d01410a0ee4,

title = "Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life",

abstract = "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.",

keywords = "atherosclerosis, brain, lacunar stroke, magnetic resonance imaging, prevalence",

author = "Sanaz Sedaghat and Yuekai Ji and Empana, {Jean Philippe} and Hughes, {Timothy M.} and Mosley, {Thomas H.} and Gottesman, {Rebecca F.} and Michael Griswold and Jack, {Clifford R.} and Lutsey, {Pamela L.} and {Van Sloten}, {Thomas T.}",

note = "Funding Information: The ARIC study (Atherosclerosis Risk in Communities) is performed as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, 75N92022D00005). The ARIC Neurocognitive Study is supported by U01HL096812, U01HL096814, U01HL096899, U01HL096902, U01HL096917 from the National Institutes of Health (National Heart, Lung, and Blood Institute [NHLBI], National Institute of Neurological Disorders and Stroke, National Institute on Aging, and National Institute on Deafness and Other Communication Disorders) and with previous brain magnetic resonance imaging examinations funded by R01-HL70825 from the NHLBI. Dr Sedaghat is supported by a McKnight Clinical Translational Research Scholarship in Cognitive Aging and Age-Related Memory Loss. Dr van Sloten is supported by a VENI research grant (916.19.074) from The Netherlands Organization for Scientific Research and a Dutch Heart Foundation research grant (2018T025). Dr Lutsey is supported by K24 HL159246. Dr Gottesman is supported by the Intramural Research Program of the National Institute of Neurological Disorders and Stroke. Funding Information: Dr Mosley received grants from National Institutes of Health Clinical Center. Dr Gottesman received compensation from American Academy of Neurology for other services. The other authors report no conflicts. Publisher Copyright: {\textcopyright} 2023 Lippincott Williams and Wilkins. All rights reserved.",

year = "2023",

month = may,

day = "1",

doi = "10.1161/strokeaha.122.041374",

language = "English (US)",

volume = "54",

pages = "1280--1288",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams and Wilkins",

number = "5",

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TY - JOUR

T1 - Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life

AU - Sedaghat, Sanaz

AU - Ji, Yuekai

AU - Empana, Jean Philippe

AU - Hughes, Timothy M.

AU - Mosley, Thomas H.

AU - Gottesman, Rebecca F.

AU - Griswold, Michael

AU - Jack, Clifford R.

AU - Lutsey, Pamela L.

AU - Van Sloten, Thomas T.

N1 - Funding Information: The ARIC study (Atherosclerosis Risk in Communities) is performed as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, 75N92022D00005). The ARIC Neurocognitive Study is supported by U01HL096812, U01HL096814, U01HL096899, U01HL096902, U01HL096917 from the National Institutes of Health (National Heart, Lung, and Blood Institute [NHLBI], National Institute of Neurological Disorders and Stroke, National Institute on Aging, and National Institute on Deafness and Other Communication Disorders) and with previous brain magnetic resonance imaging examinations funded by R01-HL70825 from the NHLBI. Dr Sedaghat is supported by a McKnight Clinical Translational Research Scholarship in Cognitive Aging and Age-Related Memory Loss. Dr van Sloten is supported by a VENI research grant (916.19.074) from The Netherlands Organization for Scientific Research and a Dutch Heart Foundation research grant (2018T025). Dr Lutsey is supported by K24 HL159246. Dr Gottesman is supported by the Intramural Research Program of the National Institute of Neurological Disorders and Stroke. Funding Information: Dr Mosley received grants from National Institutes of Health Clinical Center. Dr Gottesman received compensation from American Academy of Neurology for other services. The other authors report no conflicts. Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.

PY - 2023/5/1

Y1 - 2023/5/1

N2 - 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.

AB - 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.

KW - atherosclerosis

KW - brain

KW - lacunar stroke

KW - magnetic resonance imaging

KW - prevalence

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Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life

Abstract

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