Timely and prompt cardiovascular risk factor control preserves brain metabolism

Results from recent study confirm the importance of controlling traditional cardiovascular risk factors, such as hypertension, cholesterol, diabetes, smoking, and a sedentary lifestyle, not only to preserve cardiovascular health but also to prevent Alzheimer’s disease and other dementias.

Published in The Lancet Healthy Longevity, the CNIC study shows that atherosclerosis—the accumulation of fatty deposits in the arteries—and its associated risk factors, in addition to being the main cause of cardiovascular disease, are also implicated in the cerebral alterations typically found in Alzheimer’s disease, the most frequent cause of dementia.

The PESA-CNIC-Santander study, directed by Dr. Fuster, is a prospective study that includes more than 4000 asymptomatic middle-aged participants who have been exhaustively assessed for the presence and progression of subclinical atherosclerosis since 2010.

Glucose is the main energy source for neurons and other brain cells. Dr. Gispert, an expert in neuroimaging at the CNIC and Barcelonaβeta Research Center explained, “If there is a sustained decline in cerebral glucose consumption over several years, this may limit the brain's ability to withstand neurodegenerative or cerebrovascular diseases in the future.”

The CNIC team along with collaborators discovered that the individuals showing this metabolic decline already show signs of neuronal injury. The CNIC team also discovered that the progression of subclinical atherosclerosis in the carotid arteries over 5 years is linked to a metabolic decline in brain regions vulnerable to Alzheimer’s disease, in addition to the effect of cardiovascular risk factors.

Reference: The Lancet Healthy Longevity, Article Title: Longitudinal interplay between subclinical atherosclerosis, cardiovascular risk factors, and cerebral glucose metabolism in midlife: results from the PESA prospective cohort study (DOI:https://doi.org/10.1016/S2666-7568(23)00134-4)