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Protect Your Heart and Preserve Your Brain
You know that treating vascular risk factors is vital to your heart health. Now a new study published online April 13 in Neurology shows that treating those same risk factors is vital to your brain health as well.
Researchers found that patients with mild cognitive impairment increased their risk of developing Alzheimer’s disease when they also had vascular risk factors such as hypertension, diabetes, cerebrovascular diseases, and high cholesterol levels. “I think that this is a very important study and deserves attention,” says neurologist Samuel Gandy, MD, PhD, the Mount Sinai Chair in Alzheimer’s Disease Research. “Vascular factors can be mitigated with drugs, exercise, and diet. This is actually the only known way to slow cognitive decline by treating the underlying causes.”
The decline in cognitive function. Researchers made the discovery after studying 837 people with mild cognitive impairment. After five years, 298 patients progressed to Alzheimer’s disease dementia, while 352 patients maintained only mild cognitive impairment. Patients who did not treat their vascular risk factors had a faster progression of cognitive and functional decline than the patients who treated their vascular risk factors.
Likewise, the study showed that treating all of the vascular risk factors reduced the risk of a patient’s mild cognitive impairment converting to Alzheimer’s disease. Treating even one vascular risk factor also had an effect, but it was not as significant. Dr. Gandy says that’s because the untreated vascular risk factors have a cumulative effect. “These factors act synergistically rather than additively,” he explains. “In other words, the toxicity when all are present together is greater than the sum of each individual toxicity.”
But it’s still unclear exactly how vascular risk factors are bringing on the Alzheimer’s disease. “It’s very difficult to say whether vascular disease causes ischemic damage or cholesterol damages vessels and the brain in parallel,” Dr. Gandy notes. “This is a major challenge in dementia research.”
Controlling your risk factors. What is clear from the study is that controlling your vascular risk factors is key to protecting your brain. Dr. Gandy advises his patients with mild cognitive impairment to address their vascular risk factors and take it a step further. “If blood pressure, glucose and cholesterol are under control, I urge them to undertake a physical exercise program,” he says.
The main vascular risk factors are hypertension, diabetes and high cholesterol levels. Hypertension is the medical term for high blood pressure. Dr. Gandy says the normal reading for older adults should be 120-140 over 80. Blood glucose levels (blood sugar) will help you monitor your diabetes risk, and Dr. Gandy recommends keeping your levels between 60-110 after fasting. Dr. Gandy also advises that you try to keep your total cholesterol lower than 200, your “good” cholesterol (HDL) above 60 mg/dl, and your “bad” cholesterol (LDL) under 130 mg/dl unless your doctor tells you it should be lower. Keep your triglycerides (blood fats) lower than 150.
Those are the numbers that are proven effective for heart health. Dr. Gandy reminds us, however, that we still don’t know exactly which numbers are right for good brain health. “We haven’t tested directly whether the same numbers are optimal for preventing or slowing brain blood vessel disease,” he emphasizes.
Additional benefits. Managing cardiovascular risk factors also protects the brain against stroke. When the carotid arteries, which carry blood to the brain, become blocked, you can experience an ischemic stroke, in which disruption of blood flow can cause brain tissue to die.
