Women who'd had a heart attack, in particular, were
twice as likely to see declines in their thinking and memory skills,
Doctors had already suspected such a link existed, lead author Dr.
Bernhard Haring told Reuters Health.
"But our study provides new evidence on a broad scale including many
different types of heart disease with a specific focus on
postmenopausal women," he said.
Haring is based at the Comprehensive Heart Failure Center at the
University of Würzburg in Germany.
He and his colleagues used data from a long-term study of more than
6,000 women ages 65 to 79.
Researchers asked the women if they had ever been diagnosed with any
heart problems. They also gave them a test of brain function at the
beginning of the study and then once every year.
None of the women had thinking and memory problems at the outset.
Close to 900 reported having heart disease.
About eight years later, more than 400 women showed signs of
cognitive decline or dementia. Women who said they'd had heart
disease were 29 percent more likely to have cognitive problems than
those without heart disease.
Women who'd had a heart attack had the highest risk of developing
thinking and memory trouble, the researchers reported in the Journal
of the American Heart Association.
Those with a history of bypass surgery or peripheral vascular
disease — hardening of the arteries that bring blood to the legs and
feet — were also at greater risk, Haring said.
But neither an abnormal heart rhythm nor heart failure was linked to
a decline in brain function.
Regardless of whether women had heart disease, those with high blood
pressure and diabetes had a higher risk of cognitive decline. But no
link was seen with obesity.
The new study is important because of the sheer number of women
involved, Dr. Richard O'Brien said. He is chairman of Neurology at
Johns Hopkins Bayview Medical Center in Baltimore, Maryland, and
wasn't involved in the research.
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Understanding the connection between heart disease and dementia
is important because heart disease is reversible but Alzheimer's
disease is not, O'Brien said.
"Given that the number of individuals suffering from dementia is
increasing in all developed countries, it is important and necessary
to first investigate the reasons of why this is happening and to
identify those particularly at risk and second to find measures on
how to prevent and treat affected individuals," Haring said.
An aging circulatory system could lead to worsening brain function
in many ways, he said. Gradual buildup of plaque in the veins and
arteries or inflammation may play a role, as could small bits of
tissue death in the brain over time due to poor blood supply.
"Heart disease is more than just blocked arteries, it's an
inflammatory process as well and also affects the turnover of brain
endothelial cells, cerebrospinal fluid production (which washes away
bad things in the brain) — lots of things," O'Brien told Reuters
Health in an email. "Which exactly is the most important nobody
About 35 percent of people over age 80 have dementia, he noted.
Women with any kind of heart disease should see their doctor on a
regular basis, Haring said.
"Cardiovascular risk factors such as hypertension and in particular
diabetes should be managed adequately as these may provide a link
between (heart disease) and worsening cognitive functioning over
time," Haring said.
Journal of the American Heart
Association, online Dec. 18, 2013.
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