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April 05, 2016; 86 (14) Article

Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

Nicole L. Spartano, Jayandra J. Himali, Alexa S. Beiser, Gregory D. Lewis, Charles DeCarli, Ramachandran S. Vasan, Sudha Seshadri
First published February 10, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002415
Nicole L. Spartano
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Jayandra J. Himali
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Alexa S. Beiser
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Gregory D. Lewis
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Charles DeCarli
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Ramachandran S. Vasan
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Sudha Seshadri
From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
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Citation
Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later
Nicole L. Spartano, Jayandra J. Himali, Alexa S. Beiser, Gregory D. Lewis, Charles DeCarli, Ramachandran S. Vasan, Sudha Seshadri
Neurology Apr 2016, 86 (14) 1313-1319; DOI: 10.1212/WNL.0000000000002415

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Abstract

Objective: To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life.

Methods: Framingham Offspring participants (n = 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 ± 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 ± 8 years.

Results: Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p < 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p < 0.05).

Conclusion: Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging.

GLOSSARY

BP=
blood pressure;
CARDIA=
Coronary Artery Risk Development in Young Adults Study;
CV=
cardiovascular;
CVD=
cardiovascular disease;
DBP=
diastolic blood pressure;
DEC=
duration-based exercise capacity;
ETT=
exercise treadmill test;
HR=
heart rate;
NP=
neuropsychological;
SBP=
systolic blood pressure;
TCBV=
total cerebral brain volume;
WMHV=
white matter hyperintensity volume

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received August 11, 2015.
  • Accepted in final form December 14, 2015.
  • © 2016 American Academy of Neurology
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