TY - JOUR
T1 - Associations of Arterial Stiffness With Cognitive Performance, and the Role of Microvascular Dysfunction
T2 - The Maastricht Study
AU - Rensma, Sytze P.
AU - Stehouwer, Coen D.A.
AU - van Boxtel, Martin P.J.
AU - Houben, Alfons J.H.M.
AU - Berendschot, Tos T.J.M.
AU - Jansen, Jaap F.A.
AU - Schalkwijk, Casper G.
AU - Verhey, Frans R.J.
AU - Kroon, Abraham A.
AU - Henry, Ronald M.A.
AU - Backes, Walter H.
AU - Dagnelie, Pieter C.
AU - van Dongen, Martin C.J.M.
AU - Eussen, Simone J.P.M.
AU - Bosma, Hans
AU - Köhler, Sebastian
AU - Reesink, Koen D.
AU - Schram, Miranda T.
AU - van Sloten, Thomas T.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - The mechanisms underlying cognitive impairment are incompletely understood but may include arterial stiffness and microvascular dysfunction. In the population-based Maastricht Study, we investigated the association between arterial stiffness and cognitive performance, and whether any such association was mediated by microvascular dysfunction. We included cross-sectional data of 2544 participants (age, 59.7 years; 51.0% men; 26.0% type 2 diabetes mellitus). We used carotid-femoral pulse wave velocity and carotid distensibility coefficient as measures of aortic and carotid stiffness, respectively. We calculated a composite score of microvascular dysfunction based on magnetic resonance imaging features of cerebral small vessel disease, flicker light-induced retinal arteriolar and venular dilation response, albuminuria, and plasma biomarkers of microvascular dysfunction (sICAM-1 [soluble intercellular adhesion molecule-1], sVCAM-1 [soluble vascular adhesion molecule-1], sE-selectin [soluble E-selectin], and vWF [von Willebrand factor]). Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the average of these domains. Higher aortic stiffness (per m/s) was associated with lower cognitive function (β, -0.018 SD [95% CI, -0.036 to -0.000]) independent of age, sex, education, and cardiovascular risk factors, but higher carotid stiffness was not. Higher aortic stiffness (per m/s) was associated with a higher microvascular dysfunction score (β, 0.034 SD [95% CI, 0.014 to 0.053]), and a higher microvascular dysfunction score (per SD) was associated with lower cognitive function (β, -0.089 SD [95% CI, -0.124 to -0.053]). Microvascular dysfunction significantly explained 16.2% of the total effect of aortic stiffness on cognitive function. The present study showed that aortic stiffness, but not carotid stiffness, is independently associated with worse cognitive performance, and that this association is in part explained by microvascular dysfunction.
AB - The mechanisms underlying cognitive impairment are incompletely understood but may include arterial stiffness and microvascular dysfunction. In the population-based Maastricht Study, we investigated the association between arterial stiffness and cognitive performance, and whether any such association was mediated by microvascular dysfunction. We included cross-sectional data of 2544 participants (age, 59.7 years; 51.0% men; 26.0% type 2 diabetes mellitus). We used carotid-femoral pulse wave velocity and carotid distensibility coefficient as measures of aortic and carotid stiffness, respectively. We calculated a composite score of microvascular dysfunction based on magnetic resonance imaging features of cerebral small vessel disease, flicker light-induced retinal arteriolar and venular dilation response, albuminuria, and plasma biomarkers of microvascular dysfunction (sICAM-1 [soluble intercellular adhesion molecule-1], sVCAM-1 [soluble vascular adhesion molecule-1], sE-selectin [soluble E-selectin], and vWF [von Willebrand factor]). Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the average of these domains. Higher aortic stiffness (per m/s) was associated with lower cognitive function (β, -0.018 SD [95% CI, -0.036 to -0.000]) independent of age, sex, education, and cardiovascular risk factors, but higher carotid stiffness was not. Higher aortic stiffness (per m/s) was associated with a higher microvascular dysfunction score (β, 0.034 SD [95% CI, 0.014 to 0.053]), and a higher microvascular dysfunction score (per SD) was associated with lower cognitive function (β, -0.089 SD [95% CI, -0.124 to -0.053]). Microvascular dysfunction significantly explained 16.2% of the total effect of aortic stiffness on cognitive function. The present study showed that aortic stiffness, but not carotid stiffness, is independently associated with worse cognitive performance, and that this association is in part explained by microvascular dysfunction.
KW - albuminuria
KW - biomarkers
KW - magnetic resonance imaging
KW - microcirculation
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85084696110&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.119.14307
DO - 10.1161/HYPERTENSIONAHA.119.14307
M3 - Article
C2 - 32275192
AN - SCOPUS:85084696110
SN - 0194-911X
VL - 75
SP - 1607
EP - 1614
JO - Hypertension
JF - Hypertension
IS - 6
ER -
