Cardiovascular Health Metrics Also Help the Brain

The American Heart Association (AHA) initially defined smoking, body mass index (BMI), physical activity, diet, blood pressure, cholesterol, and glucose as determinants to an ideal cardiovascular health (CVH). However, a new study finds that these CVH factors are not limited to determining only the health of the heart. The 7 CVH metrics are also associated with slowing down the decline in cognitive performance in multiethnic population.

The AHA has established a direct relationship between the pre-defined 7 metrics and cardiovascular disease morbidity and mortality. It aims to improve CVH for all Americans by 20% by measuring progress of the metrics.

The new study, published in Journal of the American Heart Association, goes beyond heart diseases and strokes. Hannah Gardener, ScD, and fellow authors suggest that the CVH metrics are also responsible for altering cognitive aging and lead to decline of cognitive impairment in patients with neurocognitive disorders. The study aims to establish clear connections between the CVH metrics and less decline in cognitive performance.

Study Process

Northern Manhattan Study (NOMAS) is designed to determine risk factors for stroke among a racially diverse urban population. A subsample (made up of 63% Hispanic, 20% non‐Hispanic black, and 15% non‐Hispanic white residents) from NOMAS underwent repeated neuropsychological testing. All participants were older than 40 years and had never been diagnosed with a stroke.

The 4 domains of cognitive performance compared based on initial performance and decline over time were Episodic Memory, Semantic Memory, Executive Function, and Processing Speed.

The results were as follows:

• The final study consisted of 1033 participants.
• The mean age at initial cognitive assessment was 72 years, 39% were male, 19% were black, 16% were white, and 65% Hispanic.
• For the ideal target levels: 3% had 0 ideal factors, 15% had 1 factor, 33% had 2 factors, 30% had 3 factors, 14% had 4 factors, 4% had 5 factors, 1% had 6 factors, and 0% had 7 factors.

What It Means

The more the number of ideal CVH factors, better was the processing speed at initial assessment and less decline. This association was strongest for 3 of the CVH factors in particular: ideal BMI, lack of smoking, and ideal fasting glucose. When the levels of these 3 factors were ideal, the cognitive performance was better at initial assessment.

“Our data suggests that promoting ideal CVH on even a few of these factors may result in cognitive health benefits,” Dr Gardener said.

The study also highlights that the lack of ideal factors—high blood pressure, glucose, cholesterol, and BMI; poor and unhealthy diet; lack of physical activity; and smoking during adulthood—lead to impaired performance on neurocognitive assessments, as well as with decline in performance over time.

The study provides evidence that maintaining an ideal level for all the 7 CVH factors not only helps the heart, but also the brain.

“As the US population ages and the number of people at risk for cognitive impairment grows, the public health implications of targeting these modifiable risk factors will be substantial,” the study concluded.