People who have survived a heart attack appear to have a higher risk of brain decline into dementia, a new study says.
On average, heart attack survivors have a yearly 5 percent increased risk of developing cognitive impairment, researchers reported today in the journal Stroke.
“Having had a heart attack in the past may speed up the decline in memory and thinking over time,” said lead researcher Dr. Mohamed Ridha, an assistant professor of neurology at Ohio State University in Columbus.
“Given the rising burden of dementia and cognitive decline among Americans, it is important to understand how cardiovascular disease affects their brain health,” Ridha said in a news release.
“This knowledge can help heart attack survivors take steps to improve their brain health as they age.”
For the new study, researchers tracked the brain function of nearly 21,000 men and women over a 10-year period.
The participants underwent a medical interview and electrocardiogram at the start of the study to determine whether they’d had a heart attack in the past.
About 1,100 reported a heart attack, and 281 had experienced the clinical symptoms of a heart attack. Another 804 had suffered a silent heart attack, based on their ECG readings.
After that initial assessment, participants underwent a simple cognitive screening with six questions once a year for a decade.
Results showed that people who’d had a silent heart attack experienced an accelerated rate of brain decline compared to those who hadn’t had a heart attack.
This matters more for women, who more often experienced silent heart attacks, researchers said.
“Our study found that those who have had a heart attack, including silent heart attacks, are one of those groups at higher risk,” Ridha said. “It’s important for clinicians who care for heart attack
survivors to also provide counseling on ways to avoid cognitive decline and dementia.”
These results could mean that a heart attack is a red flag for circulatory problems that also can cause stroke and brain decline, said Dr. Elisabeth (Liz) Marsh, director of the Comprehensive Stroke Center at Johns Hopkins Bayview Medical Center in Baltimore.
“A previous heart attack may be a sign of more widespread blood vessel disease throughout the body, not just in the heart,” Marsh, who reviewed the findings, said in a news release.
“However, more research is needed to better understand what’s really driving this connection and how damage in different blood vessels may be linked to changes in brain health,” she added.
Research shows that Black adults experience higher rates of cardiovascular disease, including heart attacks, and often develop these conditions at a younger age due to a combination of structural inequities, barriers to preventive care, and a greater burden of risk factors, such as hypertension and diabetes.
If surviving a heart attack increases the likelihood of later cognitive decline, these disparities may extend beyond cardiovascular outcomes and contribute to widening gaps in brain health as well.
The latest findings underscore the importance of viewing cardiovascular and cognitive health as interconnected rather than separate clinical concerns.
Hypertension and type 2 diabetes — both conditions that are highly prevalent among Black adults — are well-known risk factors for both cardiovascular disease and cognitive impairment.
Following a heart attack, clinicians may consider whether aggressive management of these comorbidities could help preserve not only cardiovascular health but also cognitive function. Optimizing blood pressure, glycemic control, lipid management, sleep health, and smoking cessation may provide dual benefits for the heart and brain.
Although current guidelines don’t recommend universal cognitive screening after a myocardial infarction, this study raises important questions about whether certain patients may benefit from closer monitoring.
Clinicians caring for older Black adults and those with multiple vascular risk factors should remain alert to signs such as:
Early recognition of cognitive decline may facilitate timely referral to neurologic care, support services, and interventions that help patients maintain independence.
Advances in acute cardiac care mean that more patients are surviving heart attacks than ever before. As survival improves, attention must shift toward preserving quality of life and long-term functioning.
For Black patients, who already face disproportionate cardiovascular risks and barriers to specialty care, protecting cognitive health after a heart attack may represent an important next frontier in reducing health disparities.
More information
Johns Hopkins Bloomberg School of Public Health has more on heart health and dementia.
SOURCES: American Heart Association, news release, May 14, 2026; Stroke; May 14, 2026
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