Early Arterial Stiffness Connected to Later Cognitive Decline

By: Hannah Stuart
Thursday, September 1, 2016

Arterial stiffness in people as young as their 40s can contribute to Alzheimer’s risk, data from the Framingham Heart Study show.

Recent Research using findings from the study demonstrates that higher arterial stiffness in healthy, young adults is associated with structural damage to the brain that is connected to the development of cognitive decline and Alzheimer’s disease later in life.

The more recent study was published in the journal Stroke.

“We measured arterial stiffness at several exams,” says Sudha Seshadri, MD, Professor of Neurology, Boston University School of Medicine, and senior investigator on the Framingham Heart Study. “We related arterial stiffness to risk of developing dementia over the subsequent years of follow-up — about 10 years.”

Arterial stiffness is connected to cognitive decline through the accumulation of beta-amyloid, a protein important in the development of the neural degeneration characteristic of Alzheimer’s. Stiffness in the arteries makes it more difficult for the brain to get rid of the protein.

This multicenter study is the first to demonstrate that greater stiffness of the arteries harms the brain in ways that cause cognitive decline to begin earlier than previously believed.

“[The study] demonstrated an association between the presence of increased arterial stiffness and the presence of changes in the brain in a relatively younger age group than is usually evaluated,” says Simon W. Rabkin, MD, FRCPC, FACC, Professor of Medicine (Cardiology), Department of Medicine, University of British Columbia, who was not involved in the Stroke study but has researched links between dementia and vascular stiffness. “This research underscores the scientific statement of the American Heart Association that vascular contributions to cognitive impairment and dementia are important.”

Treatment and Prevention Implications

Based on the findings, Dr. Seshadri suggested that medications used to treat blood pressure, a determinant of arterial stiffness, may in the future be tested for effects on arterial stiffness in their trial phases.

“Some lifestyle-related changes like physical activity [also] seem to have good effects on arterial stiffness,” she says. “So these are some measures that we have at our disposal in terms of diagnosing and treating hypertension, preferentially using hypertension drugs that also reduce arterial stiffness where possible, identifying and treating insulin resistance [which affects arterial stiffness], and promoting exercise.”

Future inquiry

“This research further strengthens the proposal that there is a need to expand knowledge on the complex interplay between vascular diseases and Alzheimer’s disease pathologies in the development of cognitive impairment and Alzheimer’s disease,” Dr. Rabkin says. “Research is necessary on the treatment of vascular disease, which includes approaches not just restricted to blood pressure reduction, but rather to the mechanisms underlying vascular diseases and their relation to cognitive impairment.”

For Dr. Seshadri, future research will likely involve looking at even younger cohorts of patients — those in their 20s or 30s — to determine whether arterial stiffness at those ages could have adverse effects on cognition.