More than 200,000 people at the University of Hong Kong have shown that patients with heart failure have a higher risk of dementia

 01 

Heart failure (HF) is a complex clinical syndrome in which there are multiple interactions
between heart muscle failure and brain dysfunction.
Impaired heart function affects the structure and functional capacity of the brain, and neuronal signaling affects the cardiovascular continuum
.
In addition, neuro-cardiac feedback signals significantly contribute to the exacerbation and progression of HF and are a causal relationship
for poor HF prognosis.
The diversity and complexity of heart-brain interactions makes it difficult to form a comprehensive overview
.

2019 study

 02

In 2019, a study called "LIFE-Adult" found that a type of brain injury associated with dementia and cognitive impairment was more common
in heart failure patients as it was in patients with a history of stroke.
This brain injury is called a white matter lesion.

Studies have shown that patients with heart failure are up to 2.
5 times more likely to develop white matter lesions than those without heart failure, and patients with a history of stroke are also up to 2 times more likely
to have white matter lesions than those without a history of stroke.
Also, the longer the history of heart failure, the higher
the risk of white matter lesions.
For example, patients diagnosed with heart failure less than 3 years, 4-6 years and more than 6 years have an increased risk of white matter lesions by 1.
3, 1.
7 and 2.
9 times
, respectively.

Mild white matter lesions are more common in patients with heart failure and increase with age, while moderate to severe white matter lesions are associated with
cognitive impairment and dementia.
Specifically, 87% of heart failure patients who underwent magnetic resonance imaging (MRI) had no or mild white matter lesions, and 13% had moderate to severe white matter lesions
.

Research at the University of Hong Kong

 03 

The study included 202121 patients with heart failure from the Hong Kong Clinical Data Analysis and Reporting System (CDARS), with an average age of 75.
3 years, a median follow-up of 4.
1 years, 11.
0% of whom developed dementia, and an age-standardized incidence of dementia of 1297/10,000 in women and 744/10,000
in men.

About half of the patients have comorbidities of hypertension and cardiovascular disease, and about a quarter have atrial fibrillation, diabetes and chronic kidney disease
.
During the study period, 22,145 (11.
0%) cohorts developed new-onset dementia, of whom approximately two-thirds (64%) were women
.
Among these subtypes, the incidence of AD was 26.
8%, the incidence of VD was 18.
1%, and the incidence of unspecified dementia was 55.
1%.

Patients with new-onset dementia are older, more likely to be female, have hypertension, anaemia, stroke, peripheral vascular disease, atrial fibrillation, rheumatism, depression, and Parkinson's disease, and have a previous head injury, but are unlikely to use statins
.

The findings showed that ≥ 75-year-old people, women, anaemia, Parkinson's disease, peripheral vascular disease, and a history of stroke had a significantly increased
risk of dementia.
Age ≥ 75 years (17.
4%) and women (10.
2%) had the highest
attribution risk.
Patients with heart failure who develop dementia have a 3.
5-fold increased risk of all-cause mortality, a 4.
4-fold increased risk of cardiovascular death, and a 2.
8-fold
increased risk of non-cardiovascular mortality.

Although the mechanism is unclear, reduced left ventricular ejection fraction and output in patients with heart failure play a role
.
Inflammation, autonomic disorders, and hypercoagulable states may also contribute to dementia
.
Patients with heart failure who develop dementia develop further malnutrition, sarcopenia, and cachexia, increasing the risk of
all-cause mortality.

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style="white-space: normal;box-sizing: border-box;">Note: This article is intended to introduce the progress of medical research and cannot be used as a reference
for treatment options.
If you need health guidance, please go to a regular hospital
.