Vascular dementia, which is directly tied to heart health, is considered the second most common type of dementia after Alzheimer’s disease. Considering this relationship between heart disease and dementia, I was eager to hear more about study data being presented at the annual Heart Failure Society of America meeting in Las Vegas last Tuesday.
The meeting highlighted a landmark study, known as the CHAMPION study, which focused on 550 patients with class III heart failure and chronic kidney disease. These study volunteers were implanted with a high-tech device called the CardioMEMS Heart Sensor. The CardioMems Heart Sensor is the first and only FDA-approved heart failure monitoring device that has been proven to significantly reduce hospital admissions for patients with heart failure.
Dr. William T. Abraham, MD, FACP, FACC, FAHA, FESC, Professor of Medicine, Physiology, and Cell Biology is Cardiovascular Medicine Director at Ohio State University.
As one of the lead authors in the study, Dr. Abraham kindly took some time away from his duties at the meeting to answer my questions about the relationship of heart disease to vascular dementia.
Dr. Abraham, how much truth is there in the saying that what is good for the heart is also good for the brain?
I think that there’s an awful lot of truth in that saying. So much so, that at Ohio State University we are developing an integrative heart/brain program. The heart and brain are intimately connected so that what affects one affects the other. So, we really want people to start thinking of both together.
Where do you stand on the cholesterol question? The brain needs cholesterol but too much LDL can injure the cardiovascular system. What is now considered ideal when it comes to cholesterol balance?
It turns out that lowering high LDL, “bad cholesterol,” is good for the brain as well as for the heart. We know that the same type of vascular disease (hardening of the arteries) that occurs in the heart and can cause heart attack occurs in the brain and can cause a stroke, as well. So, really our goals in treating the heart are very much the same.
In patients that have no risk factors for either cardiovascular or cerebral vascular disease, we generally like to see that LDL at least under 130 – and frankly closer to 100. In those who have risk factors, we want that LDL under 100. And in those who have established disease, such as hardening of the arteries, we want that LDL under 70.
Some studies have said statins can cause memory issues while others say they are good for people at risk for dementia. Where do you stand on statins?
My experience with statins in regard to this issue on memory has been positive. I do believe that it helps prevent the development of cognitive dysfunction or dementia as we get older, although I believe that there are some folks who might – as a side effect or adverse effect – have some trouble with memory. So, I think that this is a very individual thing… but fortunately I think that the number of patients in whom statins have a detrimental (more than a positive) affect is very small.
Do you feel heart problems in middle age could contribute to vascular dementia in a person’s later years?
Absolutely. This is very important and really relevant to one of the things that I specialize in, which is heart failure. As folks get into their middle ages and move on beyond that (age) their risk of heart failure becomes substantial. There are nearly six million Americans who suffer from heart failure and that number is growing every year. There are more than a million hospitalizations each year for heart failure in the United States. And heart failure is largely a disease of the middle and elderly ages. Heart failure is the most common cause of hospitalization after the age of 65 years and it does, again, tie back to the brain and this issue of cognitive dysfunction.
The key is that we need to manage the heart failure to keep the brain healthy and one of the ways we can do that now is with this new technology, the CardioMems heart failure system. The CardioMems is the first and only FDA heart failure monitoring device proven to significantly reduce heart failure admissions when used by physicians to manage heart failure patients. So, when we keep the heart healthy in this example we can keep the brain healthy because the heart’s got to pump blood to the brain and when the heart fails it doesn’t do a very good job of that.
Thank you Dr. Abraham. I appreciate your taking the time from your conference to answer my questions about heart health as it relates to vascular dementia.
For more information on the CardioMems implant and other heart related issues go to St. Jude Medical’s Heart Failure Answers.
Published On: September 18, 2014