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Midlife heart disease risk factors harder on the brain in women than men

Reuters Health - 05/01/2022 - Midlife cardiovascular conditions or risk factors such as diabetes, heart disease and dyslipidemia, may pose a greater threat to thinking and memory in women than men, according to a new study.

"Although it is important to treat cardiovascular conditions and risk factors for both women and men, these results suggest that women with these factors in midlife may be more susceptible to cognitive decline and should be monitored more closely," Dr. Michelle Mielke of the Mayo Clinic in Rochester, Minnesota, told Reuters Health by email.

"Recently, a few studies have shown that cardiovascular factors in midlife are associated with midlife cognition. However, these studies have generally not examined sex differences," Dr. Mielke explained. "Given the higher prevalence of vascular conditions and risk factors for men in midlife, we wanted to see if there were sex differences in relation to cognition."

The researchers looked at 1,857 people participating in the Mayo Clinic Study of Aging who were 50 to 69 years old and free of dementia at baseline. They underwent a battery of cognitive tests every 15 months for an average of three years.

Overall, 1,465 (79%) had at least one CV condition or risk factor and this was much more common in men than women (83.4% vs. 74.5%; P<0.0001).

"Most CV conditions were more strongly associated with cognition among women; coronary heart disease and other cardiovascular conditions were associated with global cognition decline only in women (all P<0.05)," the researchers report in Neurology.

"Additionally, diabetes, dyslipidemia, and coronary heart disease were associated with language z-score decline only in women (all P<0.05)," they add. Congestive heart failure was associated with language score decline only in men.

"Despite the higher prevalence of these conditions and risk factors in men, we found that women who had the risk factors and conditions had more cognitive decline in mid-life. Thus, the cardiovascular conditions and risk factors in mid-life are more detrimental to women's cognitive health," Dr. Mielke told Reuters Health.

Potential reasons for a differential impact of CV risk factors on cognition for women include hormones, structural brain development, genetics and psychosocial and lifestyle factors.

"Middle-aged adults, especially women, with some cardiovascular conditions or risk factors, such as hypertension and diabetes mellitus, may represent critical subgroups for early monitoring. In addition, there is a need to investigate whether the duration and response to treatment for these cardiovascular conditions in men and women may underlie disparities in cognitive and brain aging outcomes," the researchers note in their paper.

SOURCE: https://bit.ly/3sWZGqP Neurology, online January 5, 2022.

By Megan Brooks

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