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J Gerontol A Biol Sci Med Sci. 2019 Feb 23. pii: glz039. doi: 10.1093/gerona/glz039. [Epub ahead of print]

Carotid intima-media thickness and markers of brain health in a bi-racial middle-aged cohort: CARDIA Brain MRI Sub-study.

Author information

1
National Institute of Mental Health, Klecany, Czech Republic.
2
Third Faculty of Medicine, Charles University Prague, Czech Republic.
3
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, United States of America.
4
Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, United States of America.
5
Karolinska University Hospital, Geriatric Clinic, Stockholm, Sweden.
6
Division of Epidemiology and Community Health, University of Minnesota, United States of America.
7
Department of Radiology, University of Pennsylvania, Philadelphia, United States of America.

Abstract

BACKGROUND:

We investigated whether carotid intima-media thickness (cIMT) is associated with measures of cerebral blood flow (CBF), white matter hyperintensities and brain volume in a bi-racial cohort of middle-aged individuals.

METHODS:

We performed a cross-sectional cohort study based on data from a multicenter, population-based study Coronary Artery Risk Development in Young Adults (CARDIA). Using linear and logistic regression, we estimated the association of the composite cIMT measured in 3 segments of carotid arteries (common carotid artery, carotid artery bulb and internal carotid artery) with volume (cm3) and CBF (ml/100 g/min) in the total brain and gray matter as well as volume of white matter hyperintensities (cm3).

RESULTS:

461 participants (54% women, 34% African Americans) were included in the analysis. Greater cIMT was associated with lower CBF in gray matter (ß=-1.36; p=0.04) and total brain (ß=-1.26; p=0.04), adjusting for age, sex, race, education and total brain volume. The associations became statistically non-significant after further controlling for cardiovascular risk factors. CIMT was not associated with volumes of total brain, gray matter and white matter hyperintensities.

CONCLUSIONS:

This study suggests that lower CBF in middle-age is associated with markers of atherosclerosis in the carotid arteries. This association may reflect early long-term exposure to traditional cardiovascular risk factors. Early intervention on atherosclerotic risk factors may modulate the trajectory of CBF as people age and develop brain pathology.

KEYWORDS:

brain perfusion; carotid intima-media thickness; epidemiology

PMID:
30796828
DOI:
10.1093/gerona/glz039

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