Author + information
- Received March 3, 2014
- Revision received June 9, 2014
- Accepted June 10, 2014
- Published online October 1, 2014.
- Joseph I. Friedman, MD∗,†,‡∗ (, )
- Cheuk Y. Tang, PhD∗,§,
- Hans J. de Haas, BSC, BA‖,
- Lisa Changchien, MD∗,‡,
- Georg Goliasch, MD, PhD‖,
- Puneet Dabas, MD‡,
- Victoria Wang, BS§,
- Zahi A. Fayad, PhD§,¶,#,
- Valentin Fuster, MD¶,# and
- Jagat Narula, MD§,¶,#
- ∗Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- †Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
- ‡Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York
- §Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
- ‖Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York
- ¶Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- #Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Reprint requests and correspondence:
Dr. Joseph I. Friedman, Department of Psychiatry, Box 1230, The Mount Sinai Hospital, One Gustave L. Levy Place, New York, New York 10029.
Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients’ clinical course.
- cerebral blood flow
- glucose metabolic rate
- gray matter
- metabolic syndrome
- vascular risk factor
- white matter
Dr. Narula has received research grants from GE Healthcare and Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 3, 2014.
- Revision received June 9, 2014.
- Accepted June 10, 2014.
- American College of Cardiology Foundation