ArticleCirculation2014
Early adult to midlife cardiovascular risk factors and cognitive function.
Article in Circulation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 182 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
182 citing papers in PubMed, 6 syntheses or guidelines pooled it, 302 citations in OpenAlex.
- Cumulative blood pressure and risk of dementia and cognitive decline: a systematic review and meta-analysis.The journal of prevention of Alzheimer's disease · 2026Pooled it
- Does Gender Influence the Relationship Between High Blood Pressure and Dementia? Highlighting Areas for Further Investigation.Journal of Alzheimer's disease : JAD · 2020Pooled it
- The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019Guideline
- Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- Association Between Atrial Fibrillation and Dementia: A Meta-Analysis.Frontiers in aging neuroscience · 2019Pooled it
- Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis.Journal of Alzheimer's disease : JAD · 2017Pooled it
- Arterial stiffness moderates the link between NfL and cognition: The IGNITE study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Trial
- Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension.Journal of human hypertension · 2023Trial
- Snacking on Whole Almonds for Six Weeks Increases Heart Rate Variability during Mental Stress in Healthy Adults: A Randomized Controlled Trial.Nutrients · 2020Trial
- Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease.Journal of the American Heart Association · 2019Trial
- Importance of Hypercortisolism in BP Control, Cardiovascular Risk and in Patients With Difficult-to-Control Hypertension: An Overview for Primary Care Physicians.Diabetes, obesity & metabolism · 2026Review
- Cardiovascular Health at Midlife and Alzheimer Disease Biomarkers.medRxiv : the preprint server for health sciences · 2026Article
- The Association Between Social Determinants of Health and Alzheimer Disease Blood Biomarkers in Midlife.medRxiv : the preprint server for health sciences · 2026Article
- Elevated Cumulative Blood Pressure is Associated With Cognitive Decline: A Nationwide Population-Based Cohort Study.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Cumulative Blood Pressure as a Marker of Early Cognitive Decline.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Coronary Artery Calcium Progression and Cognitive Function in Midlife-The Coronary Artery Risk Development in Young Adults (CARDIA) Study.Circulation. Population health and outcomes · 2026Article
- Time-averaged cumulative pulse pressure in midlife and incident atrial fibrillation: the atherosclerosis risk in communities study.Journal of human hypertension · 2026Article
- Early-life blood pressure and midlife brain and cognitive health: tests in two birth cohorts.Brain communications · 2026Article
- SCORE2 cardiovascular risk score for cognitive impairment in women aged 40 years and above: a pragmatic triage signal in primary care - a single-center family medicine feasibility study with machine learning support.Frontiers in medicine · 2026Article
- The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
122 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundStudies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. METHODS AND
resultsIn a prospective study of 3381 adults (age, 18-30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010-2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education (P<0.05 for all). Fewer significant associations were observed for cholesterol.
conclusionsCumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.