Common Cardiovascular Lifestyle Risk Factors All Linked with Decreased Brain Health

Common cardiac lifestyle risk factors like smoking, diabetes, obesity, and hypertension are all associated with less health vasculature within the brain, according to new results published in the European Heart Journal.

Researchers for the study examined the brain scans of 9,772 participants enrolled in the UK Biobank study, looking for associations between vascular risk factors (such as smoking, body mass index, waist-to-hip ratio, obesity, cholesterol levels), and brain structural and diffusion MRI markers.

“We compared people with the most vascular risk factors with those who had none, matching them for head size, age and sex,” Dr. Simon Cox, a senior research associate at Centre for Cognitive Ageing and Cognitive Epidemiology at the University of Edinburgh, said in a press release about the study. “We found that, on average, those with the highest vascular risk had around 18 mL (or nearly 3%) less volume of grey matter, and one-and-a-half times the damage to their white matter […] compared to people who had the lowest risk.”

According to the study results, a higher number of risk factors was linked with greater brain atrophy, lower grey matter volume, and poorer white matter health.  While the associations were small, the degree of the association increased. Interestingly, hypercholesterolemia was the only risk factor not associated with any unique MRI marker.

“The large UK Biobank sample allowed us to take a comprehensive look at how each factor was related to many aspects of brain structure,” said Dr. Cox. “We found that higher vascular risk is linked to worse brain structure, even in adults who were otherwise healthy. These links were just as strong for people in middle-age as they were for those in later life, and the addition of each risk factor increased the size of the association with worse brain health.”

Link with Dementia

The study explained that higher aggregate vascular risk was linked with multiple MRI markers of dementia risk, including “lower frontal and temporal cortical volumes, lower subcortical volumes, higher white matter hyperintensity volumes, and poorer white matter microstructure in association with thalamic pathways.” Additionally, risk factors such as smoking pack years, hypertension and diabetes showed a consistent association across all measurements of brain structure.

Lifestyle factors are much easier to change than things like your genetic code – both of which seem to affect susceptibility to worse brain and cognitive ageing,” Dr. Cox said. “Because we found the associations were just as strong in mid-life as they were in later life, it suggests that addressing these factors early might mitigate future negative effects. These findings might provide an additional motivation to improve vascular health beyond respiratory and cardiovascular benefits.”