Stroke. 2024 Dec;55(12):e425-e438. doi: 10.1161/STR.0000000000000476. Epub 2024 Oct 10.
The burden of neurologic diseases, including stroke and dementia, is expected to grow substantially in the coming decades. Thus, achieving optimal brain health has been identified as a public health priority and a major challenge. Cardiovascular diseases are the leading cause of death and disability in the United States and around the world. Emerging evidence shows that the heart and the brain, once considered unrelated organ systems, are interdependent and linked through shared risk factors. More recently, studies designed to unravel the intricate pathogenic mechanisms underpinning this association show that people with various cardiac conditions may have covert brain microstructural changes and cognitive impairment. These findings have given rise to the idea that by addressing cardiovascular health earlier in life, it may be possible to reduce the risk of stroke and deter the onset or progression of cognitive impairment later in life. Previous scientific statements have addressed the association between cardiac diseases and stroke. This scientific statement discusses the pathogenic mechanisms that link 3 prevalent cardiac diseases of adults (heart failure, atrial fibrillation, and coronary heart disease) to cognitive impairment.
神经疾病(包括中风和痴呆)的负担预计在未来几十年内会大幅增加。因此,实现最佳的大脑健康已被确定为公共卫生的重点和主要挑战。心血管疾病是美国和全球范围内的主要死亡和残疾原因。新出现的证据表明,心脏和大脑曾经被认为是互不相关的器官系统,实际上是相互依存的,并通过共同的风险因素联系在一起。最近,旨在揭示这种关联背后复杂发病机制的研究表明,患有各种心脏疾病的人可能存在隐匿性脑微观结构变化和认知障碍。这些发现使人们产生了这样一种想法,即通过在生命早期就关注心血管健康,有可能降低中风的风险,并阻止认知障碍在生命后期的发生或进展。之前的科学声明已经探讨了心脏疾病与中风之间的关联。本科学声明讨论了将 3 种常见的成人心脏疾病(心力衰竭、心房颤动和冠心病)与认知障碍联系起来的发病机制。