B3665 - Early life exposure to cardiovascular risk factors and cerebral structure and function in young adults - 02/12/2020

B number: 
Principal applicant name: 
Scott Chiesa | UCL (UK)
Dr Sana Suri, Professor Klaus Ebmeier, Professor John Deanfield, Georgios Georgiopoulos
Title of project: 
Early life exposure to cardiovascular risk factors and cerebral structure and function in young adults
Proposal summary: 

Certain behavioural (e.g. diet, smoking, physical activity) and physiological (e.g. obesity, cholesterol, glycaemic control, blood pressure) risk factors have long been known to increase risk of atherosclerotic CVD in later life. Although clinical events rarely occur prior to middle-age, our group have previously shown that early signs of damage to the vasculature can be detectable from as early as childhood (Charakida et al 2012 JACC; Dangardt et al 2019 Lancet Child and Adolescent Health; Chiesa et al JACC Imaging 2019), and that cumulative exposure to this damage across the lifespan likely represents one of the biggest causes of later-life events.

Intriguingly, recent research strongly suggests that these modifiable health behaviours and risk factors may also contribute to another of the world's most pressing global health crises – dementia. A wealth of recent research supports the concept that the development and progression of cognitive decline and eventual dementia can be slowed or perhaps even prevented by addressing various risk factors more commonly linked to CVD (Livingstone et al 2020 Lancet). The implementation of early-life prevention strategies to improve heart health may therefore also provide dual benefits for long-term brain health.

Our group and others have recently contributed to accumulating evidence suggesting that it is exposure to these CV risk factors earlier in the lifespan which appear to relate most strongly to risk of cerebral (i.e. brain) disease risk in later life. These findings suggest that although dementia diagnoses are almost exclusively made in older age, they may in fact represent the end result of cumulative damage to brain tissues which have been sustained over decades previously. However, how early this damage starts and what factors are responsible for its appearance is currently unknown, as very few populations are available in which detailed brain scans have been carried out on a young population with wide-ranging CVD risk factors.

Impact of research: 
It is currently not known how early in life adverse changes within the cerebral tissues and circulation begin to appear, and whether the brain may be negatively impacted by childhood and adolescent exposure to risk factors in the same way as we have previously shown in the arteries. This study will provide a unique opportunity to investigate the effect that cumulative exposure to these risk factors has on markers of cerebral damage which are known to link to cognitive decline in older populations, and may therefore provide the first evidence of an adverse impact on the brain from poor health behaviours in the earliest stages of life. These findings are likely to be of wide interest to the scientific community and may inform prevention strategies for cerebral health by identifying a previously unappreciated but crucial window for targeting poor health behaviours.
Date proposal received: 
Tuesday, 24 November, 2020
Date proposal approved: 
Wednesday, 2 December, 2020
Epidemiology, Cognitive impairment, Hypertension, Obesity, CVD, Medical imaging, epidemiology, Ageing, Blood pressure, BMI, Cardiovascular, Cognition - cognitive function, Equipment - MRI, Neurology