Statin contribution to middle cerebral artery blood flow velocity in older adults at risk for dementia

Eur J Appl Physiol. 2022 Nov;122(11):2417-2426. doi: 10.1007/s00421-022-05022-1. Epub 2022 Aug 12.

Abstract

Purpose: It is plausible that statins could improve cerebral blood flow through pleiotropic mechanisms. The purpose of this investigation was to assess the contribution of statins to cerebrovascular variables in older adults with dyslipidemia and familial history of dementia. Furthermore, we explored the interaction between statin use and sex due to prevalent bias in statin trials.

Methods: Middle cerebral artery blood flow velocity (MCAv) was measured using transcranial Doppler ultrasound. Continuous supine rest recordings lasted 8 min. Participants included in analyses were statin (n = 100) or non-statin users (n = 112).

Results: MCAv and cerebrovascular conductance were significantly higher in statin users (p = 0.047; p = 0.04), and pulsatility index (PI) was significantly lower in statin users (p < 0.01). An interaction effect between statin use and sex was present for PI (p = 0.02); female statin users had significantly lower cerebrovascular resistance than the other three groups.

Conclusion: In this cross-sectional analysis, statin use was positively associated with cerebrovascular variables in older adults at risk for dementia. Female statin users had significantly higher resting MCAv and cerebrovascular conductance than female non-statin users. The greatest contribution of statin use was the association with reduced cerebrovascular resistance. Given that cerebrovascular dysregulation is one of the earliest changes in Alzheimer's disease and related dementia pathology, targeting the cerebrovasculature with statins may be a promising prevention strategy.

Keywords: Alzheimer’s disease; Cerebral blood flow velocity; Cerebrovascular; Dementia; Statin.

MeSH terms

  • Aged
  • Alzheimer Disease*
  • Blood Flow Velocity / physiology
  • Cerebrovascular Circulation / physiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / physiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors