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Hidden brain damage increases risk of stroke and dementia And what does the heart have to do with it?

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A major study has revealed a disturbing link between heart disease and hidden brain changes. The study, published in the journal Neurology®, analyzed data from more than 13,000 people and found a high prevalence of cerebrovascular abnormalities in people with various heart diseases.

These changes in the brain, often undetectable without imaging, can significantly increase the risk of stroke and dementia. It is noteworthy that these changes occurred even in those who had not previously experienced a stroke. “People with cardiovascular disease are much more likely to have these hidden vascular problems,” explains Zien Zhou, lead author of the study. “However, they often go undetected because routine brain scans are not standard practice unless a stroke has already occurred.”

The study looked at five common heart conditions: atrial fibrillation, coronary artery disease, heart failure, heart valve disease and PFO (hole in the heart).

About a third of participants with heart disease showed signs of silent cerebral infarction (SIMI), a type of stroke without obvious symptoms. A quarter had lacunae, small cavities formed by dead nerve tissue due to blockages or leakage of blood in small arteries. Two thirds had white matter lesions, indicating damage to the protective layer surrounding the nerve fibers. A quarter had asymptomatic microbleeds—tiny bleeding into brain tissue. More than half experienced brain atrophy, a reduction in brain size due to loss of neurons or weakened connections.

Importantly, the prevalence of these underlying brain changes was similar regardless of previous stroke or gender. Dr. Zhou emphasizes that heart disease is a major contributor to this “brain fragility.”

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