Association of Cardiovascular Risk Factors with Cerebral Perfusion in Whites and African Americans

Area of Science:

• Neuroscience
• Cardiovascular Medicine
• Public Health

Background:

• Midlife cardiovascular risk factors are associated with an increased risk of Alzheimer's disease (AD).
• African Americans experience disproportionately high rates of cardiovascular disease and dementia but are underrepresented in AD research.
• There is a lack of research-based guidance for targeting vascular risk factors in diverse populations to mitigate AD risk.

Purpose of the Study:

• To investigate the relationships between specific cardiovascular risk factors and cerebral perfusion in White and African American adults.
• To examine how these relationships are influenced by race and APOE genotype in individuals at risk for AD.

Main Methods:

• Utilized pseudo-continuous arterial spin labeling MRI on 397 cognitively unimpaired adults (330 White, 67 African American).
• Employed multiple linear regression models to assess independent associations between cardiovascular risk factors and mean cerebral perfusion.
• Conducted interaction and stratified analyses to evaluate the moderating roles of APOE genotype and race.

Main Results:

• After FDR adjustment, diastolic blood pressure was significantly associated with reduced mean cerebral perfusion.
• No significant associations were found between perfusion and tobacco use, triglycerides, waist-to-hip ratio, or a composite risk score.
• Without FDR adjustment, obesity, cholesterol, and fasting glucose also showed relationships with perfusion. Race and APOE genotype did not moderate these associations.

Conclusions:

• Higher diastolic blood pressure was a stronger predictor of lower cerebral perfusion compared to other cardiovascular risk factors.
• The observed relationship between diastolic blood pressure and perfusion did not differ by race or genetic risk for AD.
• Findings underscore the importance of including underrepresented groups in neuroimaging studies and investigating modifiable risk factors for cerebrovascular health and AD risk in these populations.