Obesity, Hypertension and Brain Health

This brief review provides background information about brain health and its definition and public health importance. Within the context of brain health, we focus on two important modifiable cardiovascular risks, obesity and hypertension, and discuss mechanisms by which these factors affect brain health and recent advances in our understanding of trajectories of these risks across the lifespan.

Our understanding of obesity, hypertension and brain health has advanced beyond the categorization of these factors as binary (present, absent) variables. The study of trajectories of obesity and hypertension have taught us that the presence of these factors as early as childhood and adolescence may be a signal of brain injury and eventual cognitive impairment as early as one's late 20s or early 30s. Over time each factor may show variability in measures and begin to decline prior to the onset of a clinical diagnosis of cognitive impairment (e.g., 5-10 years earlier). Both obesity and hypertension are key modifiable vascular factors affecting brain health via a complex relationship that exceeds a simple binary association. Primary care clinicians and public health officials are uniquely positioned to influence these factors during periods of susceptibility during the individual lifespan.