Arterial stiffness measured by pulse wave velocity correlated with cognitive decline in hypertensive individuals: A systematic review (preprint)

Background Arterial stiffness is a degenerative modification of the arterial wall significantly influencing normal aging, longevity, and vascular health. Hypertension is a major risk factor for the development of arterial stiffness, which can lead to changes in cerebral perfusion and cognitive dysfunction. This, in turn, can increase the risk of cognitive decline. Pulse wave velocity (PWV) is an established gold standard for measuring arterial stiffness. Studies have shown that individuals with hypertension and elevated PWV are more likely to experience worse cognitive decline compared to those with either condition alone. The current literature, however, demonstrates controversial results. The aim of this article is to review the most recent published studies linking arterial stiffness to cognitive function in individuals with arterial hypertension. Methods We conducted a systematic review following the Cochrane protocol that was registered through the NIHR PROSPERO system. The PRISMA 2020 guidelines were used for reporting the systematic review. PubMed, Embase, Web of Science, CINAHL, and Cochrane databases were searched for relevant publications from early June to the end of December 2022. This review includes publications with a sample size of at least 500 participants older than 45 years. Screening of abstracts and full-text review of chosen articles were carried out through the Covidence. Results A total of 434 articles were selected for the full-text review. Twenty-four longitudinal studies and four cross-sectional designs that met the inclusion criteria were selected for the comparisons. The total sample size for these studies was 56,946 individuals. Twenty-seven studies (95%) demonstrated a significant association between arterial stiffness and cognitive dysfunction in hypertensive individuals. One study reported an association between stiffness and cognition independent of blood pressure (5% of the total population). Conclusion The results of this systematic review showed that arterial hypertension is one of the most important factors linking arterial stiffness to cognitive disorders. Pulse wave velocity was shown to be a strong measure associated with cognitive decline in aging individuals with chronically elevated blood pressure. Early screening for arterial stiffness, hypertension treatment, and effective prevention of cerebrovascular disease are imperative for cognitive health. NIHR PROSPERO registry ID: CRD 42022379887

Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study: Study Design (preprint)

The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) is a national prospective study of adults at risk for coronavirus disease 2019 (COVID-19) comprising 14 established United States (US) prospective cohort studies. For decades, C4R cohorts have collected extensive data on clinical and subclinical diseases and their risk factors, including behavior, cognition, biomarkers, and social determinants of health. C4R will link this pre-COVID phenotyping to information on SARS-CoV-2 infection and acute and post-acute COVID-related illness. C4R is largely population-based, has an age range of 18-108 years, and broadly reflects the racial, ethnic, socioeconomic, and geographic diversity of the US. C4R is ascertaining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 illness using standardized questionnaires, ascertainment of COVID-related hospitalizations and deaths, and a SARS-CoV-2 serosurvey via dried blood spots. Master protocols leverage existing robust retention rates for telephone and in-person examinations, and high-quality events surveillance. Extensive pre-pandemic data minimize referral, survival, and recall bias. Data are being harmonized with research-quality phenotyping unmatched by clinical and survey-based studies; these will be pooled and shared widely to expedite collaboration and scientific findings. This unique resource will allow evaluation of risk and resilience factors for COVID-19 severity and outcomes, including post-acute sequelae, and assessment of the social and behavioral impact of the pandemic on long-term trajectories of health and aging.