VASCULAR DYSFUNCTION: AT THE HEART OF CARDIOVASCULAR DISEASE, COGNITIVE IMPAIRMENT AND DEPRESSIVE SYMPTOMS

DOI

10.1016/j.artres.2016.10.149How to use a DOI?

Abstract

Vascular dysfunction may be an important pathway through which ageing and other factors, such as diabetes and obesity, can cause diseases of the heart and brain. Vascular dysfunction includes dysfunction of large arteries (due to arterial stiffness), the microcirculation (microvascular dysfunction) and endothelium (endothelial dysfunction). We have investigated, in a series of epidemiological studies, the role of vascular dysfunction in the pathogenesis of cardiovascular disease, dementia and depression. Data were used of The Hoorn Study, The AGES-Reykjavik Study, The Maastricht Study and The SUVIMAX2 Study. In addition, we did two systematic reviews and an individual participant data meta-analysis.

We found that stiffening of the carotid artery is independently associated with incident stroke, but not with coronary heart disease. Furthermore, carotid stiffness improved stroke risk prediction beyond Framingham and cfPWV. In addition, femoral artery stiffening was independently associated with incident cardiovascular disease.

Brain MRI studies showed that cerebral small vessel disease is associated with cognitive decline and incident depressive symptoms. In addition, arterial stiffening was associated with cognitive impairment and depressive symptoms, and this association was mediated by cerebral small vessel disease. We also found that endothelial dysfunction is associated with more depressive symptoms. Finally, we showed the presence of interaction (synergy) with regard to cardiovascular risk, between endothelial dysfunction and type 2 diabetes.

From a clinical point of view, these associations are important as they suggest that efforts at favourably influencing vascular dysfunction can have significant public health implications via prevention of cardiovascular disease, dementia and depression.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - Thomas van Sloten
PY  - 2016
DA  - 2016/11/24
TI  - VASCULAR DYSFUNCTION: AT THE HEART OF CARDIOVASCULAR DISEASE, COGNITIVE IMPAIRMENT AND DEPRESSIVE SYMPTOMS
JO  - Artery Research
SP  - 46
EP  - 46
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.149
DO  - 10.1016/j.artres.2016.10.149
ID  - vanSloten2016
ER  -