Dataset Information

Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.

ABSTRACT:

Background

Cardiometabolic disorders (hypertension, diabetes) are key modifiable risk factors for Alzheimer's disease and related disorders. They often co-occur; yet, the extent to which they independently affect brain structure and function is unclear.

Objective

We hypothesized their combined effect is greater in associations with cognitive function and neuroimaging biomarkers of white matter (WM) health and cerebral perfusion in a diverse older adult cohort.

Methods

Participants aged 50-85 years received: clinical evaluation, oral glucose tolerance testing, neuroimaging, cognitive testing, and adjudication. Neuroimaging included: T1 (gray [GM]/WM segmentation, regional volumes/thicknesses); FLAIR (WM hyperintensity volume [WMHv]; arterial spin labeling (cerebral blood flow); diffusion tensor imaging (fractional anisotropy [FA]); and neurite orientation dispersion and density imaging (Free Water). Hypertension (HTN) and impaired glucose tolerance (IGT) were staged and cardiometabolic status was categorized (HTN only, IGT only, IGT+HTN, neither). Multivariable linear regression modeled associations with cognitive and neuroimaging measures (covariates: age, gender, race).

Results

MRI was available for 478 participants (35% mild cognitive impairment, 10% dementia) with mean age 70±8 years, 74% with HTN, 61% with IGT, and 15% self-identified as Black/African-American. IGT+HTN was significantly associated with cognitive impairment, higher WM Free Water and WMHv, lower FA, and lower GM perfusion compared to neither factor. HTN alone was associated with poorer cognition and lower GM perfusion. Cardiometabolic factors were not associated with GM macrostructure (volumes, temporal lobe cortical thickness) or cognitive status.

Conclusion

HTN and its co-occurrence with IGT (HTN+IGT) were associated with lower global cognitive performance and reduced GM perfusion and impaired WM microstructure.

SUBMITTER: Hughes TM

PROVIDER: S-EPMC9764872 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.

Hughes Timothy M TM Lockhart Samuel N SN Suerken Cynthia K CK Jung Youngkyoo Y Whitlow Christopher T CT Bateman James R JR Williams Benjamin J BJ Espeland Mark A MA Sachs Bonnie C BC Williamson Jeff J Cleveland Maryjo M Yang Mia M Rogers Samantha S Hayden Kathleen M KM Baker Laura D LD Craft Suzanne S

Journal of Alzheimer's disease : JAD 20220101 4

<h4>Background</h4>Cardiometabolic disorders (hypertension, diabetes) are key modifiable risk factors for Alzheimer's disease and related disorders. They often co-occur; yet, the extent to which they independently affect brain structure and function is unclear.<h4>Objective</h4>We hypothesized their combined effect is greater in associations with cognitive function and neuroimaging biomarkers of white matter (WM) health and cerebral perfusion in a diverse older adult cohort.<h4>Methods</h4>Parti ...[more]

PMID: 36314205

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Project description:The objective of this study was to determine the associations between hypertensive disorders of pregnancy and early childhood cardiometabolic risk factors in the offspring. Therefore, 7794 women from the Generation Rotterdam Study were included, an ongoing population-based prospective birth cohort. Women with a hypertensive disorder of pregnancy were classified as such when they were affected by pregnancy induced hypertension, pre-eclampsia or the haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome during pregnancy. Early childhood cardiometabolic risk factors were defined as the body mass index at the age of 2, 6, 12, 36 months and 6 years. Additionally, it included systolic blood pressure, diastolic blood pressure, total fat mass, cholesterol, triglycerides, insulin and clustering of cardiometabolic risk factors at 6 years of age. Sex-specific differences in the associations between hypertensive disorders and early childhood cardiometabolic risk factors were investigated. Maternal hypertensive disorders of pregnancy were inversely associated with childhood body mass index at 12 months (confounder model: -0.15 SD, 95% CI -0.27; -0.03) and childhood triglyceride at 6 years of age (confounder model: -0.28 SD, 95% CI -0.45; -0.10). For the association with triglycerides, this was only present in girls. Maternal hypertensive disorders of pregnancy were not associated with childhood body mass index at 2, 6 and 36 months. No associations were observed between maternal hypertensive disorders of pregnancy and systolic blood pressure, diastolic blood pressure, body mass index, fat mass index and cholesterol levels at 6 years of age. Our findings do not support an independent and consistent association between maternal hypertensive disorders of pregnancy and early childhood cardiometabolic risk factors in their offspring. However, this does not rule out possible longer term effects of maternal hypertensive disorders of pregnancy on offspring cardiometabolic health.

Project description:Background Breastfeeding is associated with improved cardiometabolic profiles decades after pregnancy. Whether this association exists for women who experience hypertensive disorders of pregnancy (HDP) is unknown. The authors examined whether breastfeeding duration or exclusivity are associated with long-term cardiometabolic health, and whether this relationship differs by HDP status. Methods and Results Participants (N=3598) were from the UK ALSPAC (Avon Longitudinal Study of Parents and Children) cohort. HDP status was assessed by medical record review. Breastfeeding behaviors were assessed by contemporaneous questionnaires. Breastfeeding duration was categorized as never, <1, 1 to <3, 3 to <6, 6 to <9, and 9+ months. Breastfeeding exclusivity was categorized as never, <1, 1 to <3, and 3 to 6 months. Measures of cardiometabolic health (body mass index, waist circumference, C-reactive protein, insulin, proinsulin, glucose, lipids, blood pressure, mean arterial pressure, carotid intima-media thickness, and arterial distensibility) were measured 18 years after pregnancy. Analyses were conducted using linear regression adjusting for relevant covariates. Breastfeeding was associated with improved cardiometabolic health (lower body mass index, waist circumference, C-reactive protein, triglycerides, insulin, and proinsulin) in all women, but not for every breastfeeding duration. Interaction tests revealed additional benefits in women with a history of HDP, with the strongest benefit observed in the 6- to 9-month breastfeeding category (diastolic blood pressure, -4.87 mm Hg [95% CI, -7.86 to -1.88], mean arterial pressure -4.61 [95% CI, -7.45 to -1.77], and low-density lipoprotein cholesterol, -0.40 mmol/L [95% CI, -0.62 to -0.17 mmol/L]). Differences in C-reactive protein and low-density lipoprotein "survived" Bonferroni correction (P<0.001). Similar results were observed in the exclusive breastfeeding analyses. Conclusions Breastfeeding may be a mechanism to reduce the cardiovascular disease sequela associated with HDP; however, there is a need to establish whether associations reflect a causal effect.

Dataset Information

Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.

Background

Objective

Methods

Results

Conclusion

Publications

Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.

Similar Datasets

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