The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Cardiovascular and Brain Health: How are They Related?

Posted in
Live well

Friday, Sep 30, 2016

In a previous post, I discussed how the American Heart Association’s (AHA) Life’s Simple 7* score is strongly related to the risk of future heart failure and other types of cardiovascular disease later in life. The goal of Life’s Simple 7 and related AHA initiatives is to improve the cardiovascular health of all Americans by 20% by the year 2020. As our population ages, conditions affecting the brain such as dementia and memory loss are on the rise. Identifying strategies to preserve and improve brain health is a very hot topic in the research world today. While it is widely known that having a greater number of ideal cardiovascular health (CVH) factors results in a decreased risk of stroke, less is known about the relationship between these health factors and other aspects of brain health such as cognitive deficits.

Accordingly, a very recent study by Gardener et al. (2016) examined the relationship between the number of ideal cardiovascular disease health metrics and cognitive performance and decline in in the Northern Manhattan Study (NOMAS).  A group of 3298 adult men and women agreed to participate. In order to be eligible, subjects had to be over the age of 40, never diagnosed with a stroke, and had resided in Northern Manhattan for at least 3 months. A unique feature of this study was that nearly two-thirds of participants were of Caribbean Hispanic descent. This group represents a growing population that has been historically underrepresented in studies of brain health. At baseline, detailed physical and neurological exams were conducted by study physicians. Among the physical measures were body mass index, resting blood pressure, fasting blood glucose and blood cholesterol levels. Standardized questionnaires were used to assess smoking habits, diet, and leisure time physical activity. These measures and questionnaires are the components of the AHA Life’s Simple 7. The neurological tests included Episodic and Semantic Memory*, Processing Speed*, and Executive Function*, as well as standardized tests for depression. All neurological testing was repeated an average of 6.2 years after the baseline testing. The researchers wanted to determine the relationship between the number of ideal CVH factors and cognitive function/decline over time.

At baseline, an increasing number of ideal cardiovascular health (CVH) factors were positively related to Processing Speed. The association was particularly strong for individuals with ideal body mass index (BMI), who were non-smokers and had ideal fasting glucose levels. Having an increasing number of ideal CVH factors was also related with less of a decline over time in Processing Speed. Similarly, those with 2 to 7 ideal CVH factors had less of a decline in episodic memory over time when compared with those with only 0 or 1 ideal CVH factor. A significant association was also seen in the number of ideal CVH factors and decline in executive function over time. Changes in semantic memory over time were not associated with the number of ideal CVH factors.  

In this same population, researchers had previously showed that the number of ideal CVH factors was strongly related to the future risk of cardiovascular disease. However, up to this point there was limited data regarding the relationship between the number of ideal CVH factors and cognitive aging, particularly within a multiethnic population. An important feature of this study is that it measured neurological changes over time rather than just reporting on the relationship between the number of ideal CVH factors and neurological function at one point in time. The researchers concluded that routine assessment and treatment of Life’s Simple 7 will lead to a reduction in cognitive impairment over the aging process.  

To learn more about healthy behaviors including physical activity and nutrition, take The Cooper Institute’s Coaching Healthy Behaviors and/or Nutrition for Health and Fitness courses. You need not be a health and fitness professional to take our courses, everyone is welcome!
*The 7 ideal cardiovascular health factors in Life’s Simple 7 are: not smoking, body mass index <25 kg/m2, resting blood pressure <120/80 mmHg, total cholesterol level <200 mg/dl, fasting blood glucose level <100 mg/dl, regular physical activity, and healthy diet.

**Episodic memory represents our memory of personal experiences, from which we are able to reconstruct the events that took place at any given point in our lives. Semantic memory is a structured record of facts and knowledge about the external world that we have acquired. Processing speed involves the ability to automatically perform relatively easy or over-learned cognitive tasks. Executive function has to do with managing oneself and one’s resources in order to achieve a goal.

Gardener, H., Wright, C. B., Dong, C., Cheung, K., DeRosa, J., Nannery, M…Sacco, R. L. Ideal cardiovascular health and cognitive aging in the northern Manhattan Study. (2016). J Am Heart Assoc, 4(3):e002731.  doi: 10.1161/JAHA.