title: Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.
abstract: Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York. Electronic address: jfriedman1@rcn.com.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Friedman
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Cheuk Y
authors.initials: CY
authors.lastname: Tang
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: de Haas
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Changchien
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.affiliation: Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York.
authors.forename: Puneet
authors.initials: P
authors.lastname: Dabas
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Victoria
authors.initials: V
authors.lastname: Wang
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
mesh_terms: D058070:Asymptomatic Diseases; D001921:Brain / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000473:pathology*; D003072:Cognition Disorders / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D009765:Obesity / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000453:epidemiology; D012307:Risk Factors; D066127:White Matter / Q000473:pathology
chemical_list: D005947:Glucose
keywords: brain; cardiovascular; cerebral blood flow; cognitive; diabetes; glucose metabolic rate; gray matter; hyperlipidemia; hypertension; imaging; metabolic syndrome; obesity; smoking; vascular risk factor; white matter