Cardiovascular disease after traumatic brain injury: the heart of the matter

The 2020 report of the Lancet Commission on dementia prevention, intervention, and care 1 Livingston G Huntley J Sommerlad A et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020; 396: 413-446 Summary Full Text Full Text PDF PubMed Scopus (3255) Google Scholar summarised the evidence for the association between traumatic brain injury (TBI) and dementia, and added TBI to a list of 11 other modifiable risk factors for this condition. Several of these modifiable risk factors are also associated with cardiovascular disease (ie, hypertension, obesity, physical inactivity, diabetes, excessive alcohol consumption, smoking, and air pollution). In The Lancet Neurology, Saef Izzy and colleagues 2 Izzy S Grashow R Radmanesh F et al. Long-term risk of cardiovascular disease after traumatic brain injury: screening and prevention. Lancet Neurol. 2023; (published online Sept 1.)https://doi.org/10.1016/S1474-4422(23)00241-7 Google Scholar summarise the evidence for the association between brain injury—a term used by the authors to describe both TBI and repetitive head impacts (RHIs)—and an increased risk of cardiovascular disease and cardiovascular risk factors. Cardiovascular disease is shown to be a modifiable mediator of the well documented association between brain injury and dementia. This notion is consistent with the evolving conceptualisation of TBI as a chronic disease, affecting multiple body systems and domains of health and function. 3 Dams-O'Connor K Juengst SB Bogner J et al. Traumatic brain injury as a chronic disease: insights from the United States Traumatic Brain Injury Model Systems Research Program. Lancet Neurol. 2023; 22: 517-528 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar Long-term risk of cardiovascular disease after traumatic brain injury: screening and preventionTraumatic brain injury (TBI) is highly prevalent among individuals participating in contact sports, military personnel, and in the general population. Although it is well known that brain injury can cause neurological and psychiatric complications, evidence from studies on individuals exposed to a single or repetitive brain injuries suggests an understudied association between TBI and the risk of developing chronic cardiovascular diseases and risk factors for cardiovascular disease. Several studies have shown that people without pre-existing comorbidities who sustain a TBI have a significantly higher risk of developing chronic cardiovascular disease, than people without TBI. Full-Text PDF