Department of Geriatrics, Tianjin Medical University General Hospital Tianjin Geriatrics Institute Tianjin China.
School of Public Health Tianjin Medical University Tianjin China.
J Am Heart Assoc. 2024 Sep 3;13(17):e033249. doi: 10.1161/JAHA.123.033249. Epub 2024 Aug 27.
High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function.
Within the UK Biobank, 349 907 HD-free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow-up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75-0.80) (including 0.68 [0.66-0.71] for coronary HD, 0.91 [0.87-0.95] for cardiac arrhythmia, and 0.63 [0.58-0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37-1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end-diastolic volume (β, 0.13 [95% CI, 0.09-0.17]), left ventricular end-systolic volume (β, 0.05 [95% CI, 0.01-0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12-0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03-0.13]).
High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.
高认知储备（CR）与较低的痴呆风险相关，但它与心脏病（HD）的关系尚不清楚。我们旨在探讨 CR 与 HD 以及心脏结构和功能的关系。
在英国生物库中，对 349907 名无 HD 的参与者进行了随访。生成了一个包含教育/职业成就/看电视时间/倾诉频率/社交联系频率/休闲活动多样性的综合 CR 指标，并进一步分为低/中/高水平。根据医疗记录确定 HD 的发病情况，包括冠心病、心律失常和心力衰竭。在随访过程中，对一个亚组（n=31182）进行了心脏磁共振成像以评估心室结构和功能。使用 Cox 回归、Laplace 回归和线性回归分析数据。与低 CR 相比，高 CR 的任何 HD 的风险比和 95%置信区间为 0.78（0.75-0.80）（包括冠心病 0.68（0.66-0.71）、心律失常 0.91（0.87-0.95）和心力衰竭 0.63（0.58-0.68））。此外，与低 CR 相比，高 CR 可使 HD 发病时间延迟 1.59 年（95%CI，1.37-1.82）。在心脏磁共振成像数据分析中，与低 CR 相比，高 CR 与更大的左心室舒张末期容积（β，0.13[95%CI，0.09-0.17]）、左心室收缩末期容积（β，0.05[95%CI，0.01-0.10]）、左心室射血分数（β，0.08[95%CI，0.03-0.13]）相关。
高 CR 与良好的 HD 健康状况相关。我们的发现表明，CR 的有益影响不仅限于痴呆症，还包括 HD。
