Top Things to Know: Impact of Sleep Disorders and Disturbed Sleep on Brain Health
Published: October 10, 2024
Prepared by Anne Leonard MPH, BSN, RN, FAHA – National Senior Director Science and Medicine
- This AHA scientific statement discusses the pathogenic mechanisms that link three prevalent cardiac diseases of adults; heart failure, atrial fibrillation, and coronary heart disease, three disorders that can lead to cognitive impairment and poor brain health.
- Recent evidence shows that the heart and the brain, once considered unrelated organ systems, are interdependent and linked through shared risk factors.
- Heart failure (HF) is associated with cognitive decline, impacting self-care, medication compliance, disease management and frailty in older adults. A systematic review showed that the prevalence of cognitive impairment in a HF cohort was 43%.
- This statement describes the mechanisms of how heart failure (HF) may cause brain injury and cognitive impairment including sympathetic nervous system activity, inflammation, hypoperfusion, brain infarction, vascular factors, neurodegenerative and genetic factors.
- Some studies have shown that cognitive disfunction appears greater in persons with heart failure with reduced ejection fraction (HFrEF) vs heart failure with preserved ejection fraction (HFpEF).
- Several large meta-analyses have shown an association atrial fibrillation (AF) with an increased risk of cognitive impairment or dementia.
- This statement describes the mechanisms elucidating how atrial fibrillation may cause cognitive impairment such as vascular risks and stroke, stroke, cerebral microhemorrhages, cardiac output, inflammation, and Alzheimer’s disease.
- The frequency of cognitive impairment in coronary heart disease (CHD) in large systematic review with about 1 million participants, the relative risk of dementia in participants with a history of CHD was 1.27 (95% CI 1.07-1.50) as compared to those without CHD.
- The mechanisms by which CHD may cause cognitive impairment include the areas of vascular risk factors and inflammation, effects on the blood brain barrier, microvascular circulation, and related cardiac sequelae.
- This statement discusses the prospects for prevention and treatment of all three of these conditions related to maintaining brain health.
Citation
Testai FD, Gorelick PB, Chuang P-Y, Dai X, Furie KL, Gottesman RF, Iturrizaga JC, Lazar RM, Russo AM, Seshadri S, Wan EY; on behalf of the American Heart Association Stroke Council; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; and Council on Hypertension. Cardiac contributions to brain health: a scientific statement from the American Heart Association. Stroke. Published online October 10, 2024. doi: 10.1161/STR.0000000000000476