Long-term risk of cardiovascular disease after traumatic brain injury: screening and prevention

Saef Izzy; Rachel Grashow; Farid Radmanesh; Patrick Chen; Herman Taylor; Rita Formisano; Fiona Wilson; Meagan Wasfy; Aaron Baggish; Ross Zafonte

doi:10.1016/S1474-4422(23)00241-7

Long-term risk of cardiovascular disease after traumatic brain injury: screening and prevention

Lancet Neurol. 2023 Oct;22(10):959-970. doi: 10.1016/S1474-4422(23)00241-7.

Authors

Saef Izzy¹, Rachel Grashow², Farid Radmanesh³, Patrick Chen⁴, Herman Taylor⁵, Rita Formisano⁶, Fiona Wilson⁷, Meagan Wasfy⁸, Aaron Baggish⁹, Ross Zafonte¹⁰

Affiliations

¹ Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Football Players Health Study at Harvard University, Boston, MA, USA.
² Department of Environmental Health, T H Chan School of Public Health, Harvard University, Boston, MA, USA; Football Players Health Study at Harvard University, Boston, MA, USA.
³ Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Division of Neurocritical Care, University of New Mexico, Albuquerque, NM, USA.
⁴ Department of Neurology, University of California Irvine, Orange, CA, USA.
⁵ Football Players Health Study at Harvard University, Boston, MA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
⁶ Lucia Foundation, Rome, Italy.
⁷ School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
⁸ Harvard Medical School, Boston, MA, USA; Cardiology Division, Massachusetts General Hospital, Boston, MA, USA.
⁹ Football Players Health Study at Harvard University, Boston, MA, USA; Institute for Sport Science and Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
¹⁰ Harvard Medical School, Boston, MA, USA; Football Players Health Study at Harvard University, Boston, MA, USA; Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: rzafonte@mgh.harvard.edu.

Abstract

Traumatic 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. Similar observations made in military and professional American-style football cohorts suggest causal pathways through which modifiable cardiovascular risk factors might mediate the relationship between brain injury and chronic neurological diseases. A better understanding of cardiovascular disease risk after TBI combined with a proactive, targeted screening programme might mitigate long-term morbidity and mortality in individuals with TBI, and improve their quality of life.

Publication types

Review

MeSH terms

Brain Injuries*
Brain Injuries, Traumatic* / complications
Brain Injuries, Traumatic* / epidemiology
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / etiology
Cardiovascular Diseases* / prevention & control
Football*
Humans
Quality of Life

Grants and funding

K08 NS123503/NS/NINDS NIH HHS/United States