Introduction: Cardiovascular health (CVH) status is associated with better cognitive function; however the cardiovascular profile integral in maintaining sound structural brain health is unclear. The purpose of this study was to assess CVH status in relation to brain structure.
Methods: Ideal cardiovascular health, defined by the American Heart Association Life’s Simple 7, was determined on 710 men and women 18-30 years of age at enrollment (1985-1986) at CARDIA exam years 0, 7, and 25. We examined the cross-sectional association between ideal cardiovascular health, at each of the 3 exams, and brain MRI measures of normal tissue of the total brain, gray matter, white matter, and volume (cm3) of abnormal tissue of white matter at exam year 25. Strata of CVH were determined according to the sum total of metrics meeting ideal criteria (0-2, 3, 4, and 5-7 total metrics meeting ideal criteria). Markov Chain Monte Carlo multiple imputation (m=10) was used to impute missing data on CVH and potential confounders. Meta-analysis multiple imputation linear and logistic regression analyses were used. Multivariable models adjusted for total intracranial volume, age, sex, race, education, study center, alcohol consumption, APOE ε allele, and use of blood pressure lowering and cholesterol lowering medication.
Results: The percent of individuals with ≥ 5 ideal cardiovascular health metrics declined from exam year 0 through 25 (52% to 18%) while the percent of individuals with ≤ 2 ideal cardiovascular health metrics increased over time (4% to 33%). After adjustment, better CVH status in year 0 and year 7 was associated with roughly 10 cm3 and 7 cm3 greater volumes in white matter by year 25, respectively. Multivariable models are presented in the table below.
Conclusion: Throughout younger adulthood, better CVH was associated with normal white matter volume in middle adulthood, but not with normal brain and gray matter volumes or abnormal white matter. Maintenance of better CVH through young adulthood may be beneficial to brain structure in midlife.