Early Vascular Aging in Obese Individuals with Low Cardiovascular Health

Cunha, Michelle Rabello; Mattos, Samanta; Klein, Márcia R. S. T.; Neves, Mário Fritsch

doi:10.1007/s40292-022-00555-0

Cited by 7 publications

(16 citation statements)

References 39 publications

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“…Higher LE8 scores were associated with lower dementia risk, better cognitive performance, and larger total brain and hippocampal volumes in 316,669 participants from the UK Biobank study [26]. Furthermore, LE8 scores were shown to be associated with CVRFs and cardiovascular disease (CVD) in previous studies [14,16,27], which, in turn, were associated with cognitive impairment and participants in the lowest quartile had a more than twofold higher risk of developing one of the CVD outcomes [16]. A cross-sectional study conducted in obese individuals evaluated the participants' anthropometric and biochemical profiles and verified that low LE8 scores were associated with higher blood pressure (peripheral and central), arterial stiffness, and endothelial dysfunctions [27].…”

Section: Discussionmentioning

confidence: 93%

“…Higher LE8 scores were associated with lower dementia risk, better cognitive performance, and larger total brain and hippocampal volumes in 316,669 participants from the UK Biobank study [26]. Furthermore, LE8 scores were shown to be associated with CVRFs and cardiovascular disease (CVD) in previous studies [14, 16, 27], which, in turn, were associated with cognitive impairment and dementia [28, 29]. A study including 250,825 participants from the UK Biobank used a modified version of the LE8 to predict the risk of developing ischemic heart disease, myocardial infarction, stroke, and heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to individuals in the highest LE8 quartile, participants in the lowest quartile had a more than twofold higher risk of developing one of the CVD outcomes [16]. A cross‐sectional study conducted in obese individuals evaluated the participants’ anthropometric and biochemical profiles and verified that low LE8 scores were associated with higher blood pressure (peripheral and central), arterial stiffness, and endothelial dysfunctions [27].…”

Section: Discussionmentioning

confidence: 99%

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Optimal cardiovascular health is associated with slower cognitive decline

Ferreira,

Gonçalves,

Szlejf

et al. 2023

Euro J of Neurology

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BackgroundLife's Simple 7, a lifestyle and cardiovascular index associated with cognition, has been updated to Life's Essential 8 (LE8) to include sleep. LE8 has been related to cardiovascular outcomes but its association with cognition is unclear.MethodsIn this longitudinal analysis of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil), LE8 score was based on health behaviors (diet, physical activity, nicotine exposure, and sleep health) as well as health‐related factors (body mass index, blood lipids, blood glucose, and blood pressure). Cognition was assessed in three waves, 4 years apart, using the Consortium to Establish a Registry for Alzheimer's Disease – Word List, semantic and phonemic verbal fluency, the Trail‐Making Test B (TMT‐B), and a global composite score. We used linear mixed‐model analysis, inverse probability weighting, and interaction analysis.ResultsAt baseline, the mean age of the study cohort was 51.4 ± 8.9 years, 56% were women, and 53% were White. Higher baseline LE8 scores were associated with slower decline in global cognition (β = 0.001, 95% confidence interval [CI] 0.001, 0.002; p < 0.001), memory (β = 0.001, 95% CI 0.000, 0.002; p = 0.013), verbal fluency (β = 0.001, 95% CI 0.000, 0.002; p = 0.003), and TMT‐B (β = 0.004, 95% CI 0.003, 0.005; p < 0.001). This association was mainly driven by LE8 health factors, particularly blood glucose and blood pressure. Age, sex, and race were modifiers of the association between LE8 and global cognitive decline (p < 0.001), suggesting it was more pronounced in older, male, and Black participants.ConclusionsHigher baseline LE8 scores were associated with slower global and domain‐specific cognitive decline during 8 years of follow‐up, mainly due to health factors such as blood glucose and blood pressure. Sociodemographic factors were modifiers of this association.

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Section: Discussionmentioning

confidence: 93%

“…Higher LE8 scores were associated with lower dementia risk, better cognitive performance, and larger total brain and hippocampal volumes in 316,669 participants from the UK Biobank study [26]. Furthermore, LE8 scores were shown to be associated with CVRFs and cardiovascular disease (CVD) in previous studies [14, 16, 27], which, in turn, were associated with cognitive impairment and dementia [28, 29]. A study including 250,825 participants from the UK Biobank used a modified version of the LE8 to predict the risk of developing ischemic heart disease, myocardial infarction, stroke, and heart failure.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Optimal cardiovascular health is associated with slower cognitive decline

Ferreira,

Gonçalves,

Szlejf

et al. 2023

Euro J of Neurology

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“…13,14 Several mechanisms contribute to this phenomenon of vascular aging, including adiposity, inflammation, and endothelial dysfunction. 15,16 Because arterial compliance is similar across sexes at birth but diverges after puberty, 17 sex and sex hormones also play a role in arterial stiffening. Recent data from the Study of Women Across the Nation show that arterial stiffness drastically increases in women within 1 year of the final menstrual period without any alterations in blood pressure, strongly indicating an essential role for estrogen in vascular homeostasis and remodeling.…”

mentioning

confidence: 99%

Ovariectomy-Induced Arterial Stiffening Differs From Vascular Aging and Is Reversed by GPER Activation

Kilanowski-Doroh,

McNally,

Wong

et al. 2024

Hypertension

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BACKGROUND: Arterial stiffness is a cardiovascular risk factor and dramatically increases as women transition through menopause. The current study assessed whether a mouse model of menopause increases arterial stiffness in a similar manner to aging and whether activation of the G-protein–coupled estrogen receptor could reverse stiffness. METHODS: Female C57Bl/6J mice were ovariectomized at 10 weeks of age or aged to 52 weeks, and some mice were treated with G-protein–coupled estrogen receptor agonists. RESULTS: Ovariectomy and aging increased pulse wave velocity to a similar extent independent of changes in blood pressure. Aging increased carotid wall thickness, while ovariectomy increased material stiffness without altering vascular geometry. RNA-sequencing analysis revealed that ovariectomy downregulated smooth muscle contractile genes. The enantiomerically pure G-protein–coupled estrogen receptor agonist, LNS8801, reversed stiffness in ovariectomy mice to a greater degree than the racemic agonist G-1. In summary, ovariectomy and aging induced arterial stiffening via potentially different mechanisms. Aging was associated with inward remodeling, while ovariectomy-induced material stiffness independent of geometry and a loss of the contractile phenotype. CONCLUSIONS: This study enhances our understanding of the impact of estrogen loss on vascular health in a murine model and warrants further studies to examine the ability of LNS8801 to improve vascular health in menopausal women. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04130516.

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“… 16 In addition, Shetty et al compared the LS7 and LE8 scores in young adults, using National Health and Nutrition Examination Survey data, revealing a discrepancy in the CVH classification between the 2 scores, with nearly half of those classified as having ideal CVH by the LS7 score being reclassified as having intermediate or poor CVH using the LE8 score. 17 Moreover, recent studies have established an inverse relation between LE8 scores and the risk of major adverse cardiac events, 18 early vascular aging in individuals with obesity, 19 and metabolic fatty liver disease, 20 , 21 as well as CVD and all‐cause mortality. 22 , 23 …”

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confidence: 99%

Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study

Rempakos,

Prescott,

Mitchell

et al. 2023

JAHA

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Background The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease (CVD) and death is not described in the FHS (Framingham Heart Study). Methods and Results We evaluated Framingham Offspring participants at examinations 2 and 6 (n=2888 and 1667; and mean age, 44 and 57 years, respectively), free of CVD with information on LE8 components. Using age‐sex–adjusted Cox models, we related LE8 and its change (examination 2 to examination 6) with CVD and death risk and compared associations with those of the Life's Simple 7 score. Mean LE8 score at examination 2 was 67 points (minimum, 26 points; maximum, 100 points). At both examinations, participants were reclassified to a different cardiovascular health status, depending on which method (LE8 versus Life's Simple 7) was used (60% of participants in ideal Life's Simple 7 status were in intermediate LE8 category). On follow‐up after examination 2 (median, 30 and 33 years for CVD and death, respectively), we observed 966 CVD events, and 1195 participants died. Participants having LE8≥68 (sample median) were at lower CVD and death risk compared with those with LE8<68 (examination 2: CVD hazard ratio [HR], 0.47 [95% CI, 0.41–0.54]; death HR, 0.55 [95% CI, 0.49–0.62]; all P <0.001). Participants maintaining low LE8 scores during life course were at highest CVD and death risk (CVD: HRs ranging from 1.8 to 2.3; P <0.001; death HR, 1.45 [95% CI, 1.13–1.85]; P =0.003 versus high‐high group). Conclusions Further studies are warranted to elucidate whether the LE8 score is a better marker of CVD and death risk, compared with Life's Simple 7 score.

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Early Vascular Aging in Obese Individuals with Low Cardiovascular Health

Cited by 7 publications

References 39 publications

Optimal cardiovascular health is associated with slower cognitive decline

Optimal cardiovascular health is associated with slower cognitive decline

Ovariectomy-Induced Arterial Stiffening Differs From Vascular Aging and Is Reversed by GPER Activation

Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study

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