Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later
Nicole L. Spartano, PhD, Jayandra J. Himali, PhD, Alexa S. Beiser, PhD, Gregory D. Lewis, MD, Charles DeCarli, MD, Ramachandran S. Vasan, MD and Sudha Seshadri, MD
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Correspondence to Dr. Spartano: spartano@bu.edu
Neurology 10.1212/WNL.0000000000002415
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.
Received August 11, 2015.
Accepted in final form December 14, 2015.
