Nicole L Spartano1, Jayandra J Himali2, Alexa S Beiser2, Gregory D Lewis2, Charles DeCarli2, Ramachandran S Vasan2, Sudha Seshadri2. 1. 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. spartano@bu.edu. 2. 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.
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.
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.
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