How does heart health affect brain health?

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Updated data from the American Heart Association (AHA) underscores the crucial link between heart and brain health. Image credit: Hiroshi Watanabe/Getty Images.
  • The AHA’s 2022 Heart Disease and Stroke Statistics Update emphasizes the two-way relationship between brain and heart health.
  • Globally, the number of dementia cases and deaths has increased alarmingly over the past 3 decades, more than heart disease.
  • Modifying cardiovascular disease risk factors, such as smoking, diabetes, high blood pressure, obesity, and high cholesterol, can promote healthy aging and prevent cognitive decline.

Current evidence suggests robustness link between brain health and cardiovascular health. Damage to the heart and blood vessels can increase the risk of stroke and dementia.

A stroke occurs when a clot blocks blood flow or when a blood vessel ruptures in the brain. Strokes cause brain tissue to die, sometimes resulting in impaired memory and profound disability.

Plus, the cumulative effect of multiple small silent strokes – what health experts call mini strokes — can cause vascular dementia. Dementia can have a detrimental impact on memory, cognitive functioning and personality.

The AHA and the National Institutes of Health (NIH) update vital statistics on heart disease and stroke each year. Their joint report highlights data related to important modifiable risk factors affecting cardiovascular health and outcomes associated with the quality of care, procedures, and economic costs of cardiovascular conditions.

The AHA’s Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee recently published “The Heart Disease and Stroke Statistics – 2022 Update: A Report From the American Heart Association” in the AHA peer-reviewed journal Traffic.

According to data from the 2020 Global Burden of Disease (GBD) study, the number of people worldwide with Alzheimer’s disease and related dementias has increased at a faster rate than those with ischemic heart disease (IC). From 1990 to 2020, the prevalence of Alzheimer’s disease and related dementias increased by approximately 144% worldwide, compared to 120% for IHD.

Study reports greater differences in death rates from Alzheimer’s disease and related dementias over the same period, with approximately 185% increase in deaths from Alzheimer’s disease and related dementias and a 66% increase in IHD-related deaths.

A systematic review of the 2017 GBD study — the most recent data available — reports that 2.9 million people in the United States had a diagnosis of Alzheimer’s disease or Alzheimer’s disease and related dementias.

It is the fourth most common neurological disorder in the United States, as well as the leading cause of death from neurological disease, surpassing strokes.

There is also a significant economic burden associated with Alzheimer’s disease and related dementias. Between 1996 and 2016, US spending on dementia doubled from about $39 billion to $79 billion.

Dr. Mitchell Elkind, AHA Past President, Professor of Neurology and Epidemiology at Columbia University Vagelos College of Physicians and Surgeons, and Assistant Neurologist at New York-Presbyterian/Columbia University Irving Medical Center in New York City, spoke maintained with Medical News Today about new updates.

“Heart disease and brain disease share many of the same risk factors. Risk factors for cardiovascular disease, or behaviors and health conditions that can lead to heart attacks, include high blood pressure, diabetes, smoking, high cholesterol, and obesity,” he explained.

“For some time we have known that these same risk factors also lead to strokes, which are damage to the brain caused by disorders of the blood vessels, i.e. vascular. What clinicians, epidemiologists and other scientists have discovered more recently is that these same risk factors also contribute to other manifestations of brain disease, such as cognitive decline and dementia, which had not previously been known. not previously recognized as such. [a] vascular disorder.

– Dr. Mitchell Elkind

The 2022 update highlights the effects of cardiovascular disease risk factors on cognitive dysfunction or the development of dementia.

In short, a meta-analysis of 139 studies demonstrated that people with high blood pressure in midlife were 55% more likely to develop impaired global cognition and about 20% more likely to suffer from impaired executive function, dementia or Alzheimer’s disease.

Another meta-analysis of four studies found that people with heart failure were 80% more likely to develop dementia, while a meta-analysis of 14 studies found that women with diabetes had a 62% risk % higher risk of developing dementia, and men had a 58%% higher risk.

In terms of obesity-related dementia risk, a meta-analysis of studies with up to 42 years of follow-up showed that obese people in mid-life had a 33% increased risk of developing dementia.

Smoking also remains an important risk factor. A meta-analysis of 37 studies found that people who smoked at the time had a 30% increased risk of dementia, a 40% increased risk of Alzheimer’s disease and a 38% increased risk of vascular dementia.

The risk of cognitive dysfunction or dementia can vary by race, ethnicity, gender, education, occupation and geography.

The 2022 update highlights an analysis of Behavioral Risk Factor Surveillance System data from 2016 that showed black adults were about three times more likely and Hispanic adults about four times more likely than white adults to need help with daily activities due to memory loss.

In addition, Alzheimer’s disease and related dementias disproportionately affect women. According to GBD data from 2020, approximately 20 million men and 35 million women worldwide have been diagnosed with Alzheimer’s disease and related dementias, with a death rate of 1.28 million for women and 0.61 million for men.

Dr Elkind commented:

“Because nearly half of all adults in the United States have high blood pressure and 40% are obese, these data give an idea of ​​what we can expect to see in the future as the population ages and the impact of these risk factors begins to be felt.Recent data suggests that globally, cases of dementia could triple over the next 3 decades, even if the diseases heart rate decrease.

Reducing risk by modifying lifestyles and behavioral risk factors can help protect people against the development of cardiovascular disease, stroke and dementia. Dr Elkind said a system-wide approach is needed to achieve long-term behavior change.

He explained, “Researchers are currently testing technologies to see if they can improve our success rates with behavioral risk factors; some of these approaches involve shifting the focus of care from the doctor’s office to the home and involving non-physician providers in management to improve efficiency. For example, can home blood pressure monitoring with a real-time connection to a doctor or nurse help improve blood pressure? »

Dr. Elkind also wondered, “Can we use non-clinical settings, such as hair salons, to reach black men and women to detect high blood pressure and make changes to their fashion? of life ? […] These types of approaches may ultimately lead to greater benefits than doctors prescribing specific drugs or trying to convince individual patients to change their behaviors.

Dr Jason Tarpley – stroke neurologist and director of the Stroke and Neurovascular Center for Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California – later commented, in an interview with DTMthat “the take home message is that much of this is preventable” through a combination of healthy diet, exercise and medication.

He added: “The information age helps people […] [P]Patients know their cholesterol level, they know their LDL, they know their hemoglobin A1C — which is a long-term measure of their blood sugar — and they know [their] blood pressure. I […] see that behaviors are changing, and I think people […] take more responsibility for their health, and that’s really good.