Lifestyle modification improves cognition in people with resistant hypertension: Study
USA: Lifestyle modification in people with resistant hypertension improves cognition, a recent study in the Journal of Hypertension has found. This appears to be associated with reduced ambulatory systolic blood pressure (SBP) changes through weight loss. Parallel improvements were also seen in endothelial and microvascular function along with cognitive improvements.
Previous studies have shown an association between resistant hypertension and an increased risk of stroke, cognitive decline, and dementia. It has been suggested that lifestyle modification may improve cognitive function through its salutary effects on vascular function.
The subjects of the study were 140 patients with resistant hypertension who were participants of the TRIUMPH trial. Participants were randomized to a cardiac rehabilitation-based lifestyle program (C-LIFE) or a standardized education and physician advice condition (SEPA). A 45-min cognitive test battery consisting of tests of Executive Functioning and Learning, Memory, and Processing Speed were completed by the participants.
The collection of vascular [flow mediated dilation of the brachial artery (FMD)], microvascular, and cerebrovascular function was also done, in addition to fitness, weight, and ambulatory blood pressure.
The average age of the participants were 63 years of age, 48% women, 59% black, and obese [mean BMI = 36 kg/m2 (SD = 4)].
Based on the study, the researchers reported the following findings:
- Cognitive performance improved across the entire cohort during the 4-month trial [t-scores pretreatment = 48.9 vs. posttreatment = 50.0].
- Postintervention Executive Function/Learning composite performance was higher for participants in C-LIFE compared to SEPA (d = 0.37).
- C-LIFE intervention effects on Memory and Processing Speed were moderated by sex and baseline stroke risk, respectively, such that males and participants with greater stroke risk showed the greatest cognitive changes. FMD [C-LIFE: +0.3% vs. SEPA: -1.4%], and microvascular function [C-LIFE: 97 vs. SEPA: 025] were improved in C-LIFE compared with SEPA, whereas cerebrovascular reactivity was not [C-LIFE: -0.2 vs. SEPA: 0.1 (-0.2, 0.4)).
- Mediation analyses suggested that increased executive function/learning was associated with reduced ambulatory SBP levels secondary to weight loss [indirect effect: B = 0.25].
"Lifestyle modification in individuals with resistant hypertension improves cognition, which appeared to be associated with reduced ambulatory SBP changes through weight loss," the authors wrote. "Cognitive improvements were accompanied by parallel improvements in microvascular and endothelial function."
Reference:
Smith, Patrick J.a; Andrew, Sherwooda; Hinderliter, Alan L.b; Mabe, Stephaniea; Watkins, Lana L.a; Craighead, Lindac; Ingle, Kristaa; Tyson, Crystald; Avorgbedor, Forgivee; Lin, Pao-Hwad; Kraus, William E.d; Liao, Lawrenced; Blumenthal, James A.a Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial, Journal of Hypertension: June 13, 2022 - Volume - Issue - 10.1097/HJH.0000000000003151 doi: 10.1097/HJH.0000000000003151
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