Williamson W, et al. - In this cross-sectional observational study, experts assessed the connections between modifiable cardiovascular risk factors and cerebrovascular structure, function, and white matter integrity in young adults. The data presented showed a higher number of modifiable cardiovascular risk factors at recommended levels was correlated to higher cerebral vessel density and caliber, higher cerebral blood flow, and fewer white matter hyperintensities.

Methods

• Study participants were 125 young adults (aged 18-40 years) without clinical evidence of cerebrovascular disease.
• Between August 2014 and May 2016, data collection was done at the University of Oxford, UK.
• On May 31, 2016, final data collection was completed.
• The number of modifiable cardiovascular risk factors at recommended levels was based on the following criteria:
• Body mass index (BMI) <2 5; highest tertile of cardiovascular fitness and/or physical activity;
• alcohol consumption < 8 drinks/week;
• nonsmoker for > 6 months;
• blood pressure on awake ambulatory monitoring <130/80 mm Hg;
• a nonhypertensive diastolic response to exercise (peak diastolic blood pressure < 90 mm Hg);
• total cholesterol < 200 mg/dL;
• and fasting glucose < 100mg/dL.
• Each risk factor at the recommended level was assigned a value of 1, and study participants were categorized from 0-8, according to the number of risk factors at recommended levels, with higher numbers showing healthier risk categories.
• Main outcomes analyzed were cerebral vessel density, caliber and tortuosity, brain white matter hyperintensity lesion count.
• In a subgroup (n=52), brain blood arrival time and cerebral blood flow evaluated by brain magnetic resonance imaging (MRI).

Results

• According to the findings, 125 study participants, mean (SD) age 25 (5) years, 49% women, with a mean (SD) score of 6.0 (1.4) modifiable cardiovascular risk factors at recommended levels, completed the cardiovascular risk assessment and brain MRI protocol.
• In multivariable models, cardiovascular risk factors were associated with cerebrovascular morphology and white matter hyperintensity count.
• It was noted that for each additional modifiable risk factor categorized as healthy, vessel density was greater by 0.3 vessels/cm³ (95% CI, 0.1-0.5; P=.003), vessel caliber was greater by 8 μm (95% CI, 3-13; P=.01), and white matter hyperintensity lesions were fewer by 1.6 lesions (95% CI, -3.0 to -0.5; P=.006).
• Cerebral blood flow varied with vessel density and was 2.5 mL/100 g/min higher for each healthier category of a modifiable risk factor (95% CI, 0.16-4.89; P=.03) among the 52 participants with available data.