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

The cardiovascular diseases and that dementia in many cases they occur together in advanced stages; However, there are few longitudinal studies in people in their mid-50s that have examined the interaction between atherosclerosis and its risk factors for brain health.

Now a study conducted at the National Center for Cardiocular Research (CNIC) provides new data on this connection and confirms the relevance Control of cardiovascular risk factors Traditionally such as high blood pressure, cholesterol, diabetes, smoking or sedentary lifestyle, not only to promote cardiovascular health, but also to prevent brain diseases or disorders such as Alzheimer’s.

Published in The lancet for healthy longevitythe study shows that the arteriosclerosis (the accumulation of fatty plaques in the arteries) and associated risk factors are not only the main causes of cardiovascular disease but are also implicated in brain changes typical of Alzheimer’s disease, the most common cause of dementia.

The information is very relevant as noisy Valentine FusterDirector-General of CNIC and one of the lead authors of the study, opens up the possibility of intervening in a malleable disorder such as cardiovascular disease to prevent the development of dementia, for which many patients have no treatment.

“The sooner we start controlling cardiovascular risk factors, the better it will be for our brains,” Fuster points out, adding, “Although we all know how important it is to take care of ourselves and control cardiovascular risk factors to to avoid a heart attack, The fact that they are related to deteriorating brain health can lead to a greater awareness of the need to adopt healthy habits in the younger stages of life.

The PESA study

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

This prospective study includes more than 4,000 asymptomatic, middle-aged participants who have been extensively evaluated for the presence and development of subclinical atherosclerosis since 2010.

One of Fuster’s teams led by Martha Cortes Canteli And Juan Domingo Gisperthave followed these people for five years and found that those who maintain high cardiovascular risk during this time experience an even greater decline in brain metabolism, which can be detected by imaging techniques such as brain imaging. B. is measured Positron Emission Tomography (PET).

“We found a three times greater decrease in brain metabolism than in people who remain at low cardiovascular risk,” he says. Catarina Tristao-PereiraFirst signatory of the new article and INPhINIT grantee of the “la Caixa” Foundation.

glucose metabolism in the brain

The authors focused on glucose, the main source of energy for neurons and other brain cells. “If the brain’s glucose consumption decreases over several years, this can limit the brain’s ability to deal with future neurodegenerative or cerebrovascular diseases,” says Gispert, expert in neuroimaging at the CNIC and the Barcelonaβeta Research Center.

In fact, CNIC researchers in collaboration with Henrik Zetterberg and Kaj Blennow from the University of Gothenburg (Sweden), world experts in determining new biomarkers in the blood, have found this metabolic decline This was partly because these individuals already had neuronal damage. “These data are particularly relevant because neuron death is an irreversible process,” notes Cortés Canteli, neuroscientist at CNIC and Miguel Servet researcher at the Fundación Jiménez Díaz health research institute.

In addition, the team found that the progression of subclinical atherosclerosis in the carotid arteries over these five years was associated with a decreased metabolism in brain regions that are susceptible to it Alzheimerin addition to the effect of the cardiovascular risk factors themselves.

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

The researchers conclude that given these results, “the carotid screening It has great potential to identify people who are vulnerable to brain damage and cognitive decline in the future.” They write: “This work could have had it important implications for clinical practice as it supports the implementation of primary cardiovascular prevention strategies at an early age as a valuable approach to brain health and longevity.”

“Although we still don’t know what impact this decline in brain metabolism may have on cognitive function, the neuronal damage already identified suggests that the sooner we start controlling cardiovascular risk factors, the better off our brains are.” emphasizes Cortés Canteli.