The recent scientific statement from the American Heart Association, published in their journal Stroke, highlights a crucial link between cardiovascular diseases and cognitive health. The paper “Cardiac Contributions to Brain Health,” delves deep into the intricate relationships among heart failure, atrial fibrillation, coronary heart disease, and cognitive impairment, including the increased risk of dementia.
This detailed review collates the latest research that explores the connections between cardiovascular well-being and brain health, specifically focusing on cognitive impairments or neuropsychological dysfunctions. The statement draws significant attention to the interconnected nature of heart and brain health, underscoring its importance for overall well-being. It also emphasizes that both stroke and cognitive decline are substantial determinants of brain health, which are chronic and disabling conditions that profoundly impact individuals and society at large. Fernando D. Testai, M.D., Ph.D., FAHA, the chair of the statement writing group and a prominent figure in neurology and rehabilitation at the University of Illinois, advocates for managing heart health from an early age. This proactive approach is essential to prevent cardiovascular diseases, protect brain health, and reduce the likelihood of cognitive decline later in life.
Dr. Testai further elaborates that dementia, often perceived as an incurable and relentless condition, might be influenced by early interventions focused on a healthy lifestyle and the treatment of vascular risk factors. Such measures could preserve normal brain function and mitigate the impact of Alzheimer’s disease and other dementias.
Specifically, heart failure, a significant public health concern linked with high blood pressure, obesity, and Type 2 diabetes, has been shown to significantly affect cognitive functions required for tasks like self-care and medication management, particularly in older adults. Studies indicate that nearly half of the individuals suffering from heart failure experience cognitive impairments that can affect language, memory, and executive functions. Heart failure may cause brain injuries through mechanisms like reduced blood flow leading to mini-strokes or silent brain injuries, chronic inflammation, and neurohormonal activation.
Similarly, atrial fibrillation, the most prevalent heart rhythm disorder among adults, has been found to increase the risk of cognitive impairment by 39%, according to a large meta-analysis. The condition, which is closely linked to stroke, also shares multiple risk factors with dementia, such as high blood pressure and Type 2 diabetes. These risk factors can induce structural and functional brain changes that lead to cognitive decline. Current treatments for atrial fibrillation, such as anti-clotting medications and rhythm control procedures like catheter ablation, may potentially reduce the risk of cognitive dysfunction.
Coronary heart disease, another focus of the statement, is also significantly associated with an increased risk of dementia and cognitive impairment. Research involving more than one million adults shows that those with heart disease are 27% more likely to develop dementia than those without. Heart attacks, in particular, are linked to a sharp decline in cognitive functions, such as memory and executive functions. Coronary heart disease impacts brain function through mechanisms like inflammation that affects the blood-brain barrier and reduced blood flow to the brain, which can lead to cognitive impairments.
The study underscores the necessity of a holistic approach to patient care that integrates heart health management throughout an individual’s life. Emphasizing prevention over cure, Dr. Testai calls for more research to solidify the understanding of how cardiovascular care can enhance brain health and how various factors such as gender, race, and ethnicity may influence the relationship between cardiovascular and brain health. The push towards early intervention and promoting heart health through resources encouraging healthy lifestyles is crucial to reducing the risk of cognitive impairment and improving overall quality of life.
More information: Fernando D. Testai et al, Cardiac Contributions to Brain Health: A Scientific Statement From the American Heart Association, Stroke. DOI: 10.1161/STR.0000000000000476
Journal information: Stroke Provided by American Heart Association
