The sooner we control cardiovascular risk factors, the better for our brain.

Monitoring hypertension, cholesterol, diabetes, smoking or a sedentary lifestyle is not only important to take care of cardiovascular health, but also to prevent diseases such as Alzheimer's. This is revealed by researchers from the National Center for Cardiovascular Research (CNIC) after studying the relationship between atherosclerosis and its risk factors on brain health.

The cardiovascular diseases and the dementia they coexist in advanced stages on many occasions; However, there are few longitudinal studies in middle-aged people, 50 years old, that have evaluated the interaction between atherosclerosis and its risk factors on brain health.

Now, research carried out at the National Cardiovascular Research Center (CNIC) provides new data on this relationship and confirms the relevance of control cardiovascular risk factors traditional, such as hypertension, cholesterol, diabetes, smoking or a sedentary lifestyle, not only to take care of cardiovascular health, but also to prevent brain diseases or disorders such as Alzheimer's.

Atherosclerosis and its risk factors cause cardiovascular disease and are also involved in brain alterations typical of Alzheimer's..

Published in The Lancet Healthy Longevity, the study shows that the atherosclerosis (the accumulation of fatty plaques in the arteries) and its associated risk factors, in addition to being the main causes of cardiovascular disease, are also involved in brain alterations typical of Alzheimer's disease, the most common cause of dementia.

The information is very relevant because, according to Valentin Fuster, general director of the CNIC and one of the main authors of the study, opens the possibility of intervening on a modifiable disorder, such as cardiovascular diseases, to prevent the development of dementia, for which there is no treatment for many patients.

“The sooner we start to control cardiovascular risk factors, the better it will be for our brain,” emphasizes Fuster, who adds: “Although we all know the importance of taking care of ourselves and controlling cardiovascular risk factors to avoid a heart attack, the fact that they are related to a deterioration in brain health can lead to a greater awareness of the need to acquire healthy habits in the younger phases of life.

The PESA study

In 2021, CNIC researchers they discovered that the presence of cardiovascular risk factors and subclinical atherosclerosis (before symptoms appear) in the carotid arteries, which supply blood to the brain, in apparently healthy 50-year-old individuals participating in the PESA-CNIC-Santander study, was associated with a lower metabolism of brain glucose. This metabolism is considered an indicator of brain health.

This prospective study includes more than 4.000 asymptomatic middle-aged participants in whom the presence and development of subclinical atherosclerosis has been exhaustively evaluated since 2010.

People with an elevated cardiovascular risk for five years experience a greater decrease in brain metabolism measured through advanced imaging techniques.

One of Fuster's teams, led by Marta Cortés Canteli y Juan Domingo Gispert, have followed these individuals over five years and have found that those who maintain a high cardiovascular risk throughout this time suffer an even greater decrease in brain metabolism measured through imaging techniques such as positron emission tomography (PET).

“We have detected a cerebral metabolic decline three times greater than that of people who remain at low cardiovascular risk,” he points out. Catarina Tristão-Pereira, first signatory of the new article and INPhINIT fellow from the ”la Caixa” Foundation.

Brain glucose metabolism

The authors looked at glucose, the main source of energy for neurons and other brain cells. “If cerebral glucose consumption decreases for several years, it can limit the brain's ability to deal with neurodegenerative or cerebrovascular diseases in the future,” says Gispert, an expert in Neuroimaging at the CNIC and the Barcelonaβeta Research Center.

In fact, in collaboration with Henrik Zetterberg and Kaj Blennow from the University of Gothenburg (Sweden), world experts in the determination of new biomarkers in blood, CNIC researchers discovered that this metabolic decline It was partly due to the fact that neuronal damage already existed in these individuals. “This data is particularly relevant since the death of neurons is an irreversible process,” emphasizes Cortés Canteli, neuroscientist at the CNIC and Miguel Servet researcher at the Jiménez Díaz Foundation Health Research Institute.

Additionally, the team found that the progression of subclinical atherosclerosis in the carotids during these five years was related to a decreased metabolism in brain regions vulnerable to Alzheimer disease, in an additive manner to the effect of the cardiovascular risk factors themselves.

“These results corroborate that imaging detection of subclinical atherosclerosis provides very relevant information,” adds Fuster, principal investigator of the PESA study. “The relationship between the brain and the heart is a fascinating topic and with this study we have seen that it begins much earlier than previously believed,” he continues.

This work supports primary cardiovascular prevention early in life as a valuable approach for healthy brain longevity..

The researchers conclude that in light of these results, “the carotid screening “It has great potential to identify people vulnerable to suffering brain disorders and cognitive decline in the future.” Thus, they write, “this work could have important implications for clinical practice as it supports the implementation of primary cardiovascular prevention strategies early in life as a valuable approach for healthy brain longevity.”

"Although we still do not know the impact that this decrease in brain metabolism may have on cognitive function, having already detected neuronal damage does indicate that the sooner we begin to control cardiovascular risk factors, the better it will be for our brain," Cortés Canteli insists.

Source: Sinc Agency