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Ji Heon Lee 1 Article
Exploring the associations between cardiovascular health measured with the CANHEART model and early cognitive impairment in a middle-aged population in Korea
Ye Jin Jeon, Ji Heon Lee, Hyeon Chang Kim, Sun Jae Jung
Epidemiol Health. 2021;43:e2021044.   Published online July 13, 2021
DOI: https://doi.org/10.4178/epih.e2021044
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Abstract
OBJECTIVES
Both cardiovascular health (CVH) and inflammation are associated with cognition, and inflammation is also associated with CVH. However, limited information has been reported on these factors in the Korean population. The objective of our study was to investigate the influence of inflammation on the association between CVH and cognition using a cross-sectional design.
METHODS
Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center baseline study. Participants who completed fasting serum analysis, questionnaires, and cognitive function tests were included in the analysis, whereas those with a history of autoimmune disease were excluded. The CVH in Ambulatory Care Research Team health index metrics, including smoking, physical activity, healthy diet, obesity, history of hypertension, and diabetes, were used to assess CVH. Cognitive function was evaluated with the Korean version of the Mini-Mental State Estimation for Dementia Screening. Inflammatory status was assessed based on a high-sensitivity C-reactive protein (hs-CRP) test.
RESULTS
Among 2,622 total participants (mean age, 57.2 years; 1,792 women), 13%, 58%, and 29% had poor, intermediate, and ideal CVH, respectively. Logistic regression analysis demonstrated that CVH was significantly associated with cognitive function only in women. A stratified analysis showed that cognitive impairment due to CVH was not associated with hs-CRP levels. When the same analyses were conducted for each CVH component, the only component affecting the association was hypertension history in men.
CONCLUSIONS
CVH is not significantly associated with cognitive decline in the middle-aged Korean population. Inflammation did not play a significant modifying role in this relationship.
Summary
Korean summary
• 본 연구는 심뇌혈관 및 대상질환원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center, CMERC) 코호트의 기반조사 데이터를 활용하여, 심혈관계건강과 인지기능 사이의 연관성을 한국 도시거주 중년인구에서 확인하고, 염증 지표인 고감도C반응단백 (high-sensitivity C-reactive protein, hs-CRP) 수준에 따른 차이를 탐색하였다. • 남성과 여성 모두에서 CANHEART health index가 낮은 집단에서 인지기능이 평균적으로 더 낮았으나, 통계적으로 유의하지는 않았다. • 염증 수준에 따른 심혈관계건강과 인지기능 사이의 연관성은 해당 연구에서는 확인할 수 없었다.
Key Message
In the Korean middle-aged population, poor cardiovascular health (CVH) assessed by CANHEART health index was associated with low cognitive function, but not statistically significant. Further investigation is suggested to develop CVH index specified in Korean populations and to estimate the association between CVH and cognitive function in larger population.

Epidemiol Health : Epidemiology and Health