According to an editorial, this is one of two reports in JAMA which draw on the Life’s Simple 7 cardiovascular health metric from the American Heart Association, which is being used to measure and promote individual- and population-level improvements in cardiovascular health. With contributions from 4 modifiable health behaviours (non-smoking, healthy diet, physical activity, and BMI) and 3 modifiable biological health factors (low BP, low cholesterol, and low fasting glucose), the score indicates the degree to which an individual’s alterable health factors are in accord with ideal cardiovascular health and optimal cerebrovascular and brain health.
The other report describes a cross-sectional study of 125 young adults without clinical evidence of cerebrovascular disease, which found that a higher number of optimal cardiovascular health metrics was correlated with higher cerebral vessel density, higher cerebral blood flow, and lower number of white matter hyperintensity lesions.
The editorial notes that as both the studies were observational they can only indicate correlation and association, not causation. Unmeasured and residual confounding is possible. The current study did not adjust for socioeconomic status, and neither study adjusted for neighborhood physical and social environments. It suggests that with these caveats and pending larger, longer trials, these 2 studies convey an immediately actionable message to clinicians, policy makers, and patients, i.e. available evidence indicates that to achieve a lifetime of robust brain health free of dementia, it is never too early or too late to strive for attainment of ideal cardiovascular health. Avoid smoking, eat a healthy diet, be physically active, maintain normal weight, and keep blood pressure, cholesterol levels, and glucose-insulin levels low.