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Yao Q, Chen L, Qu H, Fan W, He L, Li G, Hu J, Zou J, Huang G, Zeng Q. Comparable cerebral cortex activity and gait performance in elderly hypertensive and healthy individuals during dual-task walking: A fNIRS study. Brain Behav 2024; 14:e3568. [PMID: 38988039 PMCID: PMC11236899 DOI: 10.1002/brb3.3568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/02/2024] [Accepted: 05/14/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Hypertension increases the risk of cognitive impairment and related dementia, causing impaired executive function and unusual gait parameters. However, the mechanism of neural function illustrating this is unclear. Our research aimed to explore the differences of cerebral cortex activation, gait parameters, and working memory performance between healthy older adults (HA) and older hypertensive (HT) patients when performing cognitive and walking tasks. METHOD A total of 36 subjects, including 12 healthy older adults and 24 older hypertensive patients were asked to perform series conditions including single cognitive task (SC), single walking task (SW), and dual-task (DT), wearing functional near-infrared spectroscopy (fNIRS) equipment and Intelligent Device for Energy Expenditure and Activity equipment to record cortical hemodynamic reactions and various gait parameters. RESULTS The left somatosensory cortex (L-S1) and bilateral supplementary motor area (SMA) showed higher cortical activation (p < .05) than HA when HT performed DT. The intragroup comparison showed that HT had higher cortical activation (p < .05) when performing DT as SW. The cognitive performance of HT was significantly worse (p < .05) than HA when executing SC. The activation of the L-S1, L-M1, and bilateral SMA in HT were significantly higher during SW (p < .05). CONCLUSION Hypertension can lead to cognitive impairment in the elderly, including executive function and walking function decline. As a result of these functional declines, elderly patients with hypertension are unable to efficiently allocate brain resources to support more difficult cognitive interference tasks and need to meet more complex task demands by activating more brain regions.
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Affiliation(s)
- Qiuru Yao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Ling Chen
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hang Qu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Weichao Fan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Longlong He
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Gege Li
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jinjing Hu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jihua Zou
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
- Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Arif Y, Killanin AD, Zhu J, Willett MP, Okelberry HJ, Johnson HJ, Wilson TW. Hypertension Impacts the Oscillatory Dynamics Serving the Encoding Phase of Verbal Working Memory. Hypertension 2024; 81:1609-1618. [PMID: 38690668 PMCID: PMC11168866 DOI: 10.1161/hypertensionaha.124.22698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Chronic hypertension is known to be a major contributor to cognitive decline, with executive function and working memory being among the domains most commonly affected. Despite the growing literature on such dysfunction in patients with hypertension, the underlying neural processes are poorly understood. METHODS In this cross-sectional study, we examine these neural processes by having participants with controlled hypertension, uncontrolled hypertension, and healthy controls perform a verbal working memory task during magnetoencephalography. Neural oscillations associated with the encoding and maintenance components of the working memory task were imaged and statistically evaluated among the 3 groups. RESULTS Differences related to hypertension emerged during the encoding phase, where the hypertension groups exhibited weaker α-β oscillatory responses compared with controls in the left parietal cortices, whereas such oscillatory activity differed between the 2 hypertension groups in the right prefrontal regions. Importantly, these neural responses in the prefrontal and parietal cortices during encoding were also significantly associated with behavioral performance across all participants. CONCLUSIONS Overall, our data suggest that hypertension is associated with neurophysiological abnormalities during working memory encoding, whereas the neural processes serving maintenance seem to be preserved. The right hemispheric neural responses likely reflected compensatory processing, which patients with controlled hypertension may use to achieve verbal working memory function at the level of controls, as opposed to the uncontrolled hypertension group where diminished resources may have limited such additional recruitment.
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Affiliation(s)
- Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Abraham D. Killanin
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Jingqi Zhu
- University of Michigan, Ann Arbor, MI, USA
| | - Madelyn P. Willett
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Hannah J. Okelberry
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Hallie J. Johnson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
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Paradela RS, Cabella B, Nucci MP, Ferreira NV, Torres LA, Martino LM, Consolim-Colombo FM, Bortolotto LA, da Costa DI, Irigoyen MC. Computerized working memory training for hypertensive individuals with executive function impairment: a randomized clinical trial. Front Neurosci 2023; 17:1185768. [PMID: 37483358 PMCID: PMC10361818 DOI: 10.3389/fnins.2023.1185768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Hypertension is associated with working memory (WM) impairment. However, the benefits of Cogmed WM training for the hypertensive population are unknown. Therefore, we aimed to evaluate Cogmed's effects on the WM performance of hypertensive individuals with executive function (EF) impairment. Methods We included 40 hypertensive patients (aged 40-70 years, 68% female) with EF impairment. They were randomized in a 1:1 ratio to receive 10 weeks of adaptive Cogmed training or a non-adaptive control training based on online games. The primary outcome was the WM performance. The secondary outcomes were verbal memory, visuospatial ability, executive function, global cognition, and the neuronal activity measured using functional magnetic resonance imaging (fMRI) under two WM task conditions: low (memorization of 4 spatial locations) and high (memorization of 6 spatial locations). An intention-to-treat (ITT) and per-protocol (PP) analysis were performed. Results Cogmed did not show a significant effect on WM or any other cognitive outcome post-training. However, under the WM-low load and WM-high load conditions of the fMRI, respectively, the Cogmed group had an activation decrease in the right superior parietal lobe (ITT and PP analyses) and left inferior frontal lobe (PP analysis) in comparison to the control group. Conclusion The Cogmed showed no effects on the WM performance of hypertensive individuals with EF impairment. However, activation decreases were observed in frontoparietal areas related to the WM network, suggesting a more efficient neuronal activity after training.
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Affiliation(s)
- Regina Silva Paradela
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Brenno Cabella
- Institute of Theoretical Physics, São Paulo State University (IFT-UNESP), São Paulo, Brazil
| | - Mariana Penteado Nucci
- Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Naomi Vidal Ferreira
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
- Research Affairs Office, Amazonia Adventist College, Benevides, Pará, Brazil
| | - Laura Aló Torres
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiza Menoni Martino
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Luiz Aparecido Bortolotto
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Danielle Irigoyen da Costa
- Brain Institute (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Chou CC, Chien LY, Lin MF, Wang CJ, Liu PY. Effects of Aerobic Walking on Memory, Subjective Cognitive Complaints, and Brain-Derived Neurotrophic Factor Among Older Hypertensive Women. Biol Res Nurs 2022; 24:484-492. [PMID: 35507447 DOI: 10.1177/10998004221098974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background:Hypertension is prevalent in older women and is associated with increased cognitive impairment. Exercise has demonstrated beneficial effects on cognitive function, but the impact of exercise on older hypertensive women remains unclear. We investigated the effects of an aerobic walking program on memory, subjective cognitive complaints, and brain-derived neurotrophic factor in older hypertensive women. Methods: A quasi-experimental study with a pretest-posttest design was conducted. Older hypertensive women were randomly assigned to the aerobic walking group or a control group with routine care. The intervention group received a 24-week aerobic walking program. Data were collected at baseline and 24 weeks after enrollment. Participants' characteristics, memory, subjective cognitive complaints, and plasma brain-derived neurotrophic factor were analyzed. Results: The aerobic walking group (n = 30) reported improvements in total recall, delayed recall, and subjective cognitive impairment after 24 weeks of aerobic walking. Compared to the control group (n = 28), the aerobic walking group showed significantly greater improvement in delayed recall at 24 weeks. However, aerobic walking had no significant effect on subjective cognitive complaints or brain-derived neurotrophic factor. Conclusion: The aerobic walking training significantly improved memory performance among older women with hypertension. A longer randomized controlled trial with a larger sample is necessary to confirm and further explore the effects of this intervention.
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Affiliation(s)
- Cheng-Chen Chou
- Institute of Community Health Care, College of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan
| | - Chi-Jane Wang
- Department of Nursing, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan
| | - Ping-Yen Liu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, & Division of Cardiology, Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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Smith PJ, Sherwood A, Hinderliter AL, Mabe S, Tyson C, Avorgbedor F, Watkins LL, Lin PH, Kraus WE, Blumenthal JA. Cerebrovascular Function, Vascular Risk, and Lifestyle Patterns in Resistant Hypertension. J Alzheimers Dis 2022; 87:345-357. [PMID: 35275539 DOI: 10.3233/jad-215522] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impaired cerebrovascular reactivity (CVR) and blunted cerebral hemodynamic recruitment are thought to be important mechanisms linking hypertension to cerebrovascular and cognitive outcomes. Few studies have examined cardiovascular or dietary correlates of CVR among hypertensives. OBJECTIVE To delineate associations between cardiometabolic risk, diet, and cerebrovascular functioning among individuals with resistant hypertension from the TRIUMPH trial (n = 140). METHODS CVR was assessed by examining changes in tissue oxygenation (tissue oxygenation index [TOI] and oxygenated hemoglobin [HBO2]) using functional near-infrared spectroscopy (fNIRS) during a breath holding test, a standardized CVR assessment to elicit a hypercapnic response. Participants also underwent fNIRS during three cognitive challenge tasks. Vascular function was assessed by measurement of brachial artery flow mediated dilation and hyperemic flow response. Cardiometabolic fitness was assessed from peak VO2 on an exercise treadmill test and body mass index. Dietary patterns were quantified using the DASH eating score. Cognitive function was assessed using a 45-minute test battery assessing Executive Function, Processing Speed, and Memory. RESULTS Greater levels fitness (B = 0.30, p = 0.011), DASH compliance (B = 0.19, p = 0.045), and lower obesity (B = -0.30, p = 0.004), associated with greater changes in TOI, whereas greater flow-mediated dilation (B = 0.19, p = 0.031) and lower stroke risk (B = -0.19, p = 0.049) associated with greater HBO2. Similar associations were found for cerebral hemodynamic recruitment, and associations between CVR and cognition were moderated by duration of hypertension. CONCLUSION Impaired CVR elevated cardiometabolic risk, obesity, vascular function, and fitness among hypertensives.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie Mabe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Crystal Tyson
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Forgive Avorgbedor
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Lana L Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Pao-Hwa Lin
- Department of Medicine and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - William E Kraus
- Department of Medicine and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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The Dose-Response Relationships of Different Dimensions of Physical Activity with Daily Physical Function and Cognitive Function in Chinese Adults with Hypertension: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312698. [PMID: 34886423 PMCID: PMC8657437 DOI: 10.3390/ijerph182312698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the dose-response relationships of different dimensions of physical activity (intensity, time, frequency, capacity, and metabolic equivalent) with daily physical function (DPF) and cognitive function (CF) in Chinese adults with hypertension. METHODS The 6216 hypertensive patients included in this study were from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted in 2015. Physical activity (PA) was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA). Linear regression models and binary logistic regression models were established to assess the associations with indicators. RESULTS Patients with VPA have a lower probability of impaired DPF; however, patients with VPA had lower CF scores. Patients with nearly all the aspects of MPA have lower rates of impaired DPF and higher CF scores (p < 0.05). Patients with LPA have a lower probability of impaired DPF and higher CF scores. In addition, patients with between 1800 and 2999 MET-minutes per week had the lowest rates of impaired DPF (OR = 0.10, 95% CI 0.02, 0.39) and the highest CF scores (β = 3.28, 95% CI 2.25, 4.31). CONCLUSIONS This study found that patients with hypertension with moderate-intensity physical activity (nearly all aspects) and LPA had better DPF and CF. The best daily physical function and CF was with METs of 1800-2999 min per week. However, VPA should be recommended with caution in Chinese adults with hypertension.
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de Medeiros Rêgo ML, Cabral DAR, da Costa KG, Bortolotti H, Price M, Fernandes GA, Fontes EB. Systolic blood pressure mediates the association between body mass index and inhibitory control in children. Biol Psychol 2020; 157:107988. [PMID: 33188838 DOI: 10.1016/j.biopsycho.2020.107988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/26/2020] [Accepted: 11/08/2020] [Indexed: 11/25/2022]
Abstract
Here, we examine whether systolic blood pressure (SBP) mediates the relationship between body mass index (BMI) and inhibitory control in children. Twenty children with high blood pressure (HBP) were approximately matched with twenty children with low blood pressure (LBP) by fitness, BMI, somatic maturation, sex and age. Inhibitory control was measured by a cognitive Go/Nogo task, where number of commission errors during Nogo trials and reaction time during Go trials were used as performance. We compared performance between the two groups and conducted a mediation analysis using SBP as mediator of the relationship between BMI and commission errors. Results revealed that HBP children presented higher number of commission errors, compared to LBP children. Moreover, SBP mediated the relation between BMI and number of errors. Thus, early exposure to high levels of SBP can negatively impact inhibitory control and SBP acts as a mediator between BMI and inhibitory functioning in children.
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Affiliation(s)
- Maria Luíza de Medeiros Rêgo
- NeuroEx - Research Group on Physical Activity, Cognition and Behavior, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Daniel Aranha Rego Cabral
- NeuroEx - Research Group on Physical Activity, Cognition and Behavior, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; School of Kinesiology, College of Education, Auburn University, Auburn, AL, USA
| | | | - Henrique Bortolotti
- NeuroEx - Research Group on Physical Activity, Cognition and Behavior, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Menna Price
- Department of Psychology, College of Human and Health Sciences, Swansea University
| | - Gleydciane Alexandre Fernandes
- NeuroEx - Research Group on Physical Activity, Cognition and Behavior, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Eduardo Bodnariuc Fontes
- NeuroEx - Research Group on Physical Activity, Cognition and Behavior, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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Role of the prefrontal lobe in young normotensives with a family history of hypertension and hypertensives. Pflugers Arch 2019; 471:1397-1406. [PMID: 31624956 DOI: 10.1007/s00424-019-02313-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
Accumulating evidence has demonstrated a significant relationship between prefrontal lobe and hypertension. Elevated blood pressure is usually associated with a prefrontal hemodynamic abnormality. However, the detailed process is still unclear. In this study, we designed a startle protocol and tested the response of the cerebral cortex and cardiovascular system in young normotensive subjects with a family history of hypertension (FH+). Additionally, the cold forehead test (CFT) was performed in hypertensive subjects. In total, 40 young normotensive subjects (21 with FH+ and 19 without a family history of hypertension (FH-)) and 49 middle-aged subjects (21 normotensives (NT) and 28 hypertensives (HT)) were recruited. Our results showed that the magnitude of startle-evoked alpha oscillation at the parasympathetic-related prefrontal cortex (FP1 and FP2) in the FH+ group was significantly smaller than in the FH- group. Acute bradycardia (RRI increase) was observed in FH- subjects but disappeared in the FH+ group. The coupling between instant cardiac acute response (increased RRI) and prefrontal arousal (magnitude of evoked oscillation) was significantly weakened in the FH+ group compared with the FH- group. Furthermore, the decrease in HR induced by parasympathetic outflow during CFT was absent in HT subjects. Hence, we concluded that the impairment of parasympathetic outflow derived from the prefrontal lobe occurs in both healthy young offspring of hypertensive and hypertensive patients.
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da Costa KG, Price M, Bortolotti H, de Medeiros Rêgo ML, Cabral DAR, Langer RD, Fernandes GA, Elsangedy HM, Fontes EB. Fat mass predicts food-specific inhibitory control in children. Physiol Behav 2019; 204:155-161. [DOI: 10.1016/j.physbeh.2019.02.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 02/24/2019] [Accepted: 02/24/2019] [Indexed: 02/06/2023]
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10
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Rêgo MLM, Cabral DAR, Costa EC, Fontes EB. Physical Exercise for Individuals with Hypertension: It Is Time to Emphasize its Benefits on the Brain and Cognition. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2019; 13:1179546819839411. [PMID: 30967748 PMCID: PMC6444761 DOI: 10.1177/1179546819839411] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/27/2019] [Indexed: 01/01/2023]
Abstract
Hypertension affects more than 40% of adults worldwide and is associated with stroke, myocardial infarction, heart failure, and other cardiovascular diseases. It has also been shown to cause severe functional and structural damage to the brain, leading to cognitive impairment and dementia. Furthermore, it is believed that these cognitive impairments affect the mental ability to maintain productivity at work, ultimately causing social and economic problems. Because hypertension is a chronic condition that requires clinical treatment, strategies with fewer side effects and less-invasive procedures are needed. Physical exercise (PE) has proven to be an efficient and complementary tool for hypertension management, and its peripheral benefits have been widely supported by related studies. However, few studies have specifically examined the potential positive effects of PE on the brain in hypertensive individuals. This narrative review discusses the pathophysiological mechanisms that hypertension promotes in the brain, and suggests PE as an important tool to prevent and reduce cognitive damage caused by hypertension. We also provide PE recommendations for hypertensive individuals, as well as suggestions for promoting PE as a method for increasing cognitive abilities in the brain, particularly for hypertensive individuals.
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Affiliation(s)
- Maria LM Rêgo
- NEUROEX-Research Group in Physical
Activity, Cognition and Behavior, Health Science Center, Federal University of Rio
Grande do Norte, Natal/RN, Brazil
| | - Daniel AR Cabral
- NEUROEX-Research Group in Physical
Activity, Cognition and Behavior, Health Science Center, Federal University of Rio
Grande do Norte, Natal/RN, Brazil
| | - Eduardo C Costa
- GPEACE-Research Group on Acute and
Chronic Effects of Exercise, Health Science Center, Federal University of Rio Grande
do Norte, Natal/RN, Brazil
| | - Eduardo B Fontes
- NEUROEX-Research Group in Physical
Activity, Cognition and Behavior, Health Science Center, Federal University of Rio
Grande do Norte, Natal/RN, Brazil
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Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Keage HAD, Murphy KJ. A Mediterranean Diet to Improve Cardiovascular and Cognitive Health: Protocol for a Randomised Controlled Intervention Study. Nutrients 2017; 9:E145. [PMID: 28212320 PMCID: PMC5331576 DOI: 10.3390/nu9020145] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/24/2017] [Accepted: 02/09/2017] [Indexed: 02/07/2023] Open
Abstract
The Mediterranean diet has demonstrated efficacy for improving cardiovascular and cognitive health. However, a traditional Mediterranean diet delivers fewer serves of dairy and less dietary calcium than is currently recommended in Australia, which may limit long-term sustainability. The present study aims to evaluate whether a Mediterranean diet with adequate dairy and calcium can improve cardiovascular and cognitive function in an at-risk population, and thereby reduce risk of cardiovascular disease (CVD) and cognitive decline. A randomised, controlled, parallel, crossover design trial will compare a Mediterranean diet supplemented with dairy foods against a low-fat control diet. Forty participants with systolic blood pressure above 120 mmHg and at least two other risk factors of CVD will undertake each dietary intervention for eight weeks, with an eight-week washout period between interventions. Systolic blood pressure will be the primary measure of interest. Secondary outcomes will include measures of cardiometabolic health, dietary compliance, cognitive function, assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), psychological well-being and dementia risk. This research will provide empirical evidence as to whether the Mediterranean diet can be modified to provide recommended dairy and calcium intakes while continuing to deliver positive effects for cardiovascular and cognitive health. The findings will hold relevance for the field of preventative healthcare and may contribute to revisions of national dietary guidelines.
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Affiliation(s)
- Alexandra T Wade
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia.
| | - Courtney R Davis
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia.
| | - Kathryn A Dyer
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia.
| | - Jonathan M Hodgson
- School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup WA 6027, Australia.
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia.
| | - Hannah A D Keage
- Cognitive Ageing and Impairment Neurosciences, School of Psychology, Social Work and Social Policy, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia.
| | - Karen J Murphy
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia.
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Affiliation(s)
- Kevin E Meyers
- Division of Pediatric Nephrology The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia, Pennsylvania.
| | - Christine B Sethna
- Division of Pediatric Nephrology Cohen Children's Medical Center of New York New Hyde Park, New York
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