This article notes evidence for age-related arterial stiffening to start in mid-life and be correlated with damage in the brain, due to structural failure of small blood vessels, even at that age. Arterial stiffness is argued to cause hypertension, increased blood pressure that only aggravates the tendency for blood vessel failure in the brain and elsewhere. Given the realization of therapies that can address the causes of arterial stiffening, such as clearance of cross-links in blood vessel walls, everyone over the age of 30 should be treated every few years. Some of those therapies are a few years away from prototypes given sufficient funding, but funding for rejuvenation research is ever an issue.
A large, multicenter study led for the first time has shown that people as young as their 40s have stiffening of the arteries that is associated with subtle structural damage to the brain that is implicated in cognitive decline and Alzheimer's disease later in life. The study found that, among young healthy adults, higher aortic "stiffness" was associated with reduced white matter volume and decreased integrity of the gray matter, and in ages much younger than previously described. "This study shows for the first time that increasing arterial stiffness is detrimental to the brain, and that increasing stiffness and brain injury begin in early middle life, before we commonly think of prevalent diseases such as atherosclerosis, coronary artery disease or stroke having an impact."
The study also noted that elevated arterial stiffness is the earliest manifestation of systolic hypertension. The large study involved approximately 1,900 diverse participants in the Framingham Heart Study, who underwent brain magnetic resonance imaging (MRI), as well as arterial tonometry. The tests measured the force of arterial blood flow, the carotid femoral pulse wave velocity or CFPWV - the reference standard for noninvasive measurement of aortic stiffness - and its association with subtle injury to the brain's white and gray matter. The research found that increased CFPWV was associated with greater injury to the brain. The reasons this is so are complex, and more study is needed. However, with age high blood pressure causes the arteries to stiffen, further increasing blood pressure as well as increasing calcium and collagen deposits, which promotes atrophy, inflammation and further stiffening, decreasing blood flow to vital organs including the brain and promoting brain atrophy. "Our results emphasize the need for primary and secondary prevention of vascular stiffness and remodeling as a way to protect brain health."