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ARTERIAL STIFFNESS IN PEOPLE A S YOUNG A S THEIR 40S CAN CONTRIBUTE TO AL ZHEIMER'S RISK, DATA FROM THE FR AMINGHAM HE ART STUDY SHOW. BY HANNAH STUART RECENT RESEARCH USING fi ndings from the study demonstrates that higher arterial sti• ness in healthy, young adults is associ- ated with structural damage to the brain that is connected to the development of cognitive decline and Alzheimer's disease later in life. The more recent study was published in the journal Stroke. " We mea sured a r teria l stiffness at several exams," says Sudha Seshadri, MD, Professor of Neurology, Boston University School of Medicine, and senior investigator on the Framingham Heart Study. " We related arterial sti• ness to risk of develop- ing dementia over the subsequent years of follow-up — about 10 years." Arterial sti• ness is connected to cogni- tive decline through the accumulation of beta-amyloid, a protein important in the development of the neural degeneration characteristic of Alzheimer's. Sti• ness in the arteries makes it more di¢ cult for the brain to get rid of the protein. This multicenter study is the fi rst to demonstrate that greater sti• ness of the arteries harms the brain in ways that cause cognitive decline to begin earlier than previously believed. "[The study] demonstrated an associa- tion between the presence of increased arteria l stiffness and the presence of cha nges i n t he bra i n i n a relatively you n ger a ge g roup t h a n i s u s u a l ly evaluated," says Simon W. Rabkin, MD, FRCPC, FACC, Professor of Medicine (Cardiology), Department of Medicine, Universit y of British Columbia , who was not involved in the Stroke study but has researched links between dementia and vascular sti• ness. "This research underscores the scientifi c statement of the American Heart Association that va scu la r contr ibutions to cog nitive impairment and dementia are important." TREATMENT AND PREVENTION IMPLICATIONS Based on the fi ndings, Dr. Seshadri sug- gested that medications used to treat blood pressure, a determinant of arterial stiffness, may in the future be tested for e• ects on arterial sti• ness in their trial phases. "Some lifestyle-related changes like physical activity [also] seem to have good e• ects on arterial sti• ness," she says. "So these are some measures that we have at our disposal in terms of diagnosing and treating hypertension, preferentially using hypertension drugs that also reduce arterial sti• ness where possible, identifying and treating insulin resistance [which a• ects arterial sti• ness], and promoting exercise." FUTURE INQUIRY "This research further strengthens the proposal that there is a need to expand knowledge on the complex interplay between vascular diseases and Alzheimer's disease pathologies in the development of cognitive impairment and Alzheimer's disease," Dr. Rabkin says. "Research is necessary on the treatment of vascular disease, which includes approaches not just restricted to blood pressure reduction, but rather to the mechanisms underlying vascular diseases and their relation to cognitive impairment." For Dr. Seshadri, future research will likely involve looking at even younger cohorts of patients — those in their 20s or 30s — to determine whether arterial sti• ness at those ages could have adverse e• ects on cognition. ■ EARLY ARTERIAL STIFFNESS Connected to Later Cognitive Decline SPECIAL CLINICAL SECTION: MEN'S HEALTH 0 6

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