On 15 February, Dr Marta Cortes-Canteli, Prof. Valentin Fuster and colleagues published an article in the JACC journal, evaluating the link between cardiovascular risk factors and subclinical atherosclerosis with alterations in brain metabolism that may predict dementia decades before the typical age of symptom onset.
Studies have conclusively shown that cardiovascular risk factors such as high blood pressure and smoking can also increase the risk of developing dementia. However, questions still remain about the specific contribution of mid-life atherosclerosis (which describes the deposition of fat-rich plaques that cause the narrowing of arteries) to dementia risk. In their study, Dr. Cortes-Canteli sought to address some of these questions, by evaluating atherosclerotic plaque burden and brain markers of neurodegeneration in middle-aged participants in the Progression of Early Subclinical Atherosclerosis (PESA) study.
The PESA study includes asymptomatic 40 to 54-year old staff members of the Banco Santander in Madrid, who were invited to undergo cardiovascular risk factor assessment, 3D vascular imaging scans (to quantify atherosclerotic plaques in different arteries) and FDG-PET brain scans (to quantify brain hypometabolism, a marker of neurodegeneration that may predict dementia onset in later life). Evaluating data from 547 PESA participants, the researchers found that the amount of atherosclerotic plaque in the carotid arteries of participants was associated with a greater amount of brain hypometabolism, as measured using FDG-PET. They also identified strong associations between Framingham Risk Score (a generalised cardiovascular risk score), hypertension and brain hypometabolism, indicative of neurodegeneration. Looking at different areas of the brain, Dr. Cortes-Canteli and colleagues saw that cerebral areas showing hypometabolism included those known to be affected by neurodegeneration in dementia. Together, these results underline the importance of controlling and mitigating cardiovascular risk factors early in life, to increase cognitive reserve and reduce the risk of dementia in later life.
