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Hypertension. 2016 Jan;67(1):176-82. doi: 10.1161/HYPERTENSIONAHA.115.06398. Epub 2015 Nov 16.

Cerebrovascular Damage Mediates Relations Between Aortic Stiffness and Memory.

Author information

1
From the Cardiovascular Engineering, Inc, Norwood, MA (L.L.C., T.W., A.A.T., G.F.M.); Cardiovascular Research Center, Rhode Island Hospital, W. Alpert Medical School of Brown University, Providence, RI (L.L.C.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., G.E., V.G.); Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands (M.A.B.); Division of Nephrology and Department of Medicine, Tufts Medical Center, Boston, MA (L.A.I.); Faculty of Medicine, University of Iceland, Reykjavik, Iceland (T.A., V.G.); and Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD (T.B.H., L.J.L.).
2
From the Cardiovascular Engineering, Inc, Norwood, MA (L.L.C., T.W., A.A.T., G.F.M.); Cardiovascular Research Center, Rhode Island Hospital, W. Alpert Medical School of Brown University, Providence, RI (L.L.C.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., G.E., V.G.); Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands (M.A.B.); Division of Nephrology and Department of Medicine, Tufts Medical Center, Boston, MA (L.A.I.); Faculty of Medicine, University of Iceland, Reykjavik, Iceland (T.A., V.G.); and Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD (T.B.H., L.J.L.). GaryFMitchell@mindspring.com.

Abstract

Aortic stiffness is associated with cognitive decline. Here, we examined the association between carotid-femoral pulse wave velocity and cognitive function and investigated whether cerebrovascular remodeling and parenchymal small vessel disease damage mediate the relation. Analyses were based on 1820 (60% women) participants in the Age, Gene/Environment Susceptibility-Reykjavik Study. Multivariable linear regression models adjusted for vascular and demographic confounders showed that higher carotid-femoral pulse wave velocity was related to lower memory score (standardized β: -0.071±0.023; P=0.002). Cerebrovascular resistance and white matter hyperintensities were each associated with carotid-femoral pulse wave velocity and memory (P<0.05). Together, cerebrovascular resistance and white matter hyperintensities (total indirect effect: -0.029; 95% CI, -0.043 to -0.017) attenuated the direct relation between carotid-femoral pulse wave velocity and memory (direct effect: -0.042; 95% CI, -0.087 to 0.003; P=0.07) and explained ≈41% of the observed effect. Our results suggest that in older adults, associations between aortic stiffness and memory are mediated by pathways that include cerebral microvascular remodeling and microvascular parenchymal damage.

KEYWORDS:

cognition; dementia; hemodynamics; memory; vascular stiffness

PMID:
26573713
PMCID:
PMC4679440
DOI:
10.1161/HYPERTENSIONAHA.115.06398
[Indexed for MEDLINE]
Free PMC Article

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