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Sex Differences in Cardiovascular Risk and Brain Degeneration

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Credit: Mohamed_hassan/ Pixabay
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A study using UK Biobank data has found that high cardiovascular risk factors, including obesity, are linked to accelerated brain volume loss, affecting the regions in the temporal lobe that are crucial for memory and sensory processing.


The long-term observational study found that men were susceptible to the decline a decade earlier (from their mid-50s) compared to similarly-affected women (from their mid-60s).  


Professor Paul Edison at Imperial College London’s Department of Brain Sciences, who led the study, said: “It was important to learn that cardiovascular disease on dementia had such a profound influence in males a decade earlier than in females, and this was not previously known. This has significant implications for the way in which we treat cardiovascular disease in men and women to prevent dementia in future.”

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While cardiovascular disease risk factors - such as type 2 diabetes, obesity and high blood pressure -were known to be linked with a greater risk of developing dementia, researchers in this study wanted to understand what the best time to intervene with treatment to stave off the associated decline would be – and whether this differed between the sexes. 


By examining over 34,000 participants of the UK Biobank, all of whom had abdominal and brain scans, the researchers were able to identify the effect of cardiovascular risk, abdominal fat, and the fat that surrounds body organs (visceral adipose tissue) on brain changes.


Analysis of the data showed that higher levels of abdominal fat and visceral adipose tissue were associated with lower brain grey matter volume in both men and women.


This negative impact begins a decade earlier in men (mid-50s) compared to women (mid-60s), persisting for two decades and irrespective of the APOE ε4 gene - which is linked to a higher risk of developing Alzheimer’s disease.


Now, the researchers suggest that aggressively managing cardiovascular risk factors, especially before age 55, could be crucial in preventing neurodegeneration.


Professor Edison explained; “Targeting cardiovascular risk and obesity a decade earlier in males than females may be vital in preventing diseases like Alzheimer’s. It’s possible that repurposing existing drugs for obesity and cardiovascular disease are a potential way of treating this and other degenerative brain conditions.”


Reference: Nowell J, Gentleman S, Edison P. Cardiovascular risk and obesity impact loss of grey matter volume earlier in males than females. J Neurol Neurosurg Psychiatry. 2024. doi: 10.1136/jnnp-2024-333675


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