Association of arterial stiffness with progression of subclinical brain and cognitive disease

Connie W. Tsao, Jayandra J. Himali, Alexa S. Beiser, Martin G. Larson, Charles Decarli, Ramachandran S. Vasan, Gary F. Mitchell, Sudha Seshadri

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: We tested whether abnormal arterial stiffness and blood pressure would be associated with progression of brain aging measured by brain MRI and neurocognitive testing. Methods: Framingham Offspring Cohort participants (n 1,223, 61 ± 9 years, 56% women) without previous stroke or dementia underwent applanation tonometry, brain MRI, and neurocognitive testing at examination 7 (1998-2001). Follow-up brain MRI and neurocognitive testing was performed at examination 8 (2005-2008, mean interval 6.4 ± 1.3 years). We related examination 7 inverse-transformed carotid-femoral pulse wave velocity (iCFPWV), central pulse pressure (CPP), and mean arterial pressure to changes in the following variables between examinations 7 and 8: total cerebral brain volume, white matter hyperintensity volume, and performance on executive function and abstraction tasks, the Trail Making Test, Parts B and A (ΔTrails B-A), and Similarities tests. Results: Higher baseline iCFPWV and CPP were associated with greater progression of neurocognitive decline (iCFPWV and ΔTrails B-A association: SD unit change in outcome variable per SD change in tonometry variable [β] ± SE 0.10 ± 0.04, p 0.019; CPP and ΔSimilarities association: -0.08 ± 0.03, p 0.013). Higher mean arterial pressure, but not iCFPWV or CPP, was associated with increase in white matter hyperintensity volume ([β ± SE] 0.07 ± 0.03, p 0.017). No tonometry measures were associated with change in cerebral brain volume. Conclusions: In middle-aged and older adults without evidence of clinical stroke or dementia, elevated arterial stiffness and pressure pulsatility are associated with longitudinal progression of subclinical vascular brain injury and greater neurocognitive decline. Treatments to reduce arterial stiffness may potentially reduce the progression of neurovascular disease and cognitive decline.

Original languageEnglish (US)
Pages (from-to)619-626
Number of pages8
JournalNeurology
Volume86
Issue number7
DOIs
StatePublished - Feb 16 2016
Externally publishedYes

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Vascular Stiffness
Brain Diseases
Pulse Wave Analysis
Thigh
Manometry
Arterial Pressure
Brain
Blood Pressure
Dementia
Cerebrovascular Trauma
Stroke
Trail Making Test
Executive Function
Disease Progression

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Tsao, C. W., Himali, J. J., Beiser, A. S., Larson, M. G., Decarli, C., Vasan, R. S., ... Seshadri, S. (2016). Association of arterial stiffness with progression of subclinical brain and cognitive disease. Neurology, 86(7), 619-626. https://doi.org/10.1212/WNL.0000000000002368

Association of arterial stiffness with progression of subclinical brain and cognitive disease. / Tsao, Connie W.; Himali, Jayandra J.; Beiser, Alexa S.; Larson, Martin G.; Decarli, Charles; Vasan, Ramachandran S.; Mitchell, Gary F.; Seshadri, Sudha.

In: Neurology, Vol. 86, No. 7, 16.02.2016, p. 619-626.

Research output: Contribution to journalArticle

Tsao, CW, Himali, JJ, Beiser, AS, Larson, MG, Decarli, C, Vasan, RS, Mitchell, GF & Seshadri, S 2016, 'Association of arterial stiffness with progression of subclinical brain and cognitive disease', Neurology, vol. 86, no. 7, pp. 619-626. https://doi.org/10.1212/WNL.0000000000002368
Tsao CW, Himali JJ, Beiser AS, Larson MG, Decarli C, Vasan RS et al. Association of arterial stiffness with progression of subclinical brain and cognitive disease. Neurology. 2016 Feb 16;86(7):619-626. https://doi.org/10.1212/WNL.0000000000002368
Tsao, Connie W. ; Himali, Jayandra J. ; Beiser, Alexa S. ; Larson, Martin G. ; Decarli, Charles ; Vasan, Ramachandran S. ; Mitchell, Gary F. ; Seshadri, Sudha. / Association of arterial stiffness with progression of subclinical brain and cognitive disease. In: Neurology. 2016 ; Vol. 86, No. 7. pp. 619-626.
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AU - Himali, Jayandra J.

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AU - Decarli, Charles

AU - Vasan, Ramachandran S.

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AB - Objective: We tested whether abnormal arterial stiffness and blood pressure would be associated with progression of brain aging measured by brain MRI and neurocognitive testing. Methods: Framingham Offspring Cohort participants (n 1,223, 61 ± 9 years, 56% women) without previous stroke or dementia underwent applanation tonometry, brain MRI, and neurocognitive testing at examination 7 (1998-2001). Follow-up brain MRI and neurocognitive testing was performed at examination 8 (2005-2008, mean interval 6.4 ± 1.3 years). We related examination 7 inverse-transformed carotid-femoral pulse wave velocity (iCFPWV), central pulse pressure (CPP), and mean arterial pressure to changes in the following variables between examinations 7 and 8: total cerebral brain volume, white matter hyperintensity volume, and performance on executive function and abstraction tasks, the Trail Making Test, Parts B and A (ΔTrails B-A), and Similarities tests. Results: Higher baseline iCFPWV and CPP were associated with greater progression of neurocognitive decline (iCFPWV and ΔTrails B-A association: SD unit change in outcome variable per SD change in tonometry variable [β] ± SE 0.10 ± 0.04, p 0.019; CPP and ΔSimilarities association: -0.08 ± 0.03, p 0.013). Higher mean arterial pressure, but not iCFPWV or CPP, was associated with increase in white matter hyperintensity volume ([β ± SE] 0.07 ± 0.03, p 0.017). No tonometry measures were associated with change in cerebral brain volume. Conclusions: In middle-aged and older adults without evidence of clinical stroke or dementia, elevated arterial stiffness and pressure pulsatility are associated with longitudinal progression of subclinical vascular brain injury and greater neurocognitive decline. Treatments to reduce arterial stiffness may potentially reduce the progression of neurovascular disease and cognitive decline.

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