The effects of exercise on blood pressure and cognitive function in older adults with hypertension and subjective cognitive decline

Abstract

AbstractBackgroundThe impact of exercise on cognition in older adults with hypertension and subjective cognitive decline (SCD) is unclear. In this study, we examined the influence of high‐intensity interval training (HIIT) combined with mind‐motor training on cognition and systolic blood pressure (BP) in older adults with hypertension and SCD.MethodWe randomized 128 community‐dwelling older adults (age mean [SD]: 71.1 [6.7], 47.7% females) with history of hypertension and SCD to either HIIT or a moderate‐intensity continuous training (MCT) group. Both groups received 15 minutes of mind‐motor training followed by 45 minutes of either HIIT or MCT. Participants exercised in total 60 minutes/day, 3 days/week for 6 months. We assessed changes in global cognitive functioning (GCF), Trail‐Making Test (TMT), systolic and diastolic BP, and cardiorespiratory fitness, using linear mixed regression models for repeated measurements. We also determined whether changes in cardiorespiratory fitness would be associated with changes in cognition and BP using hierarchical regression models adjusting for age and years of education.ResultAfter 6 months, participants in both groups had improved cardiorespiratory fitness (F[1, 69]= 34.795, p < 0.001), TMT A (F[1, 81.51]= 26.871, p < 0.001) and B (F[1, 79.49]= 23.107, p < 0.001). Both groups also had improved diastolic BP (F[1, 87.32] = 4.392, p = 0.039), with greatest effect within the HIIT group (estimated mean change [95% CI]: ‐2.64 mmHg, [‐4.79 to ‐0.48], p = 0.017),but no between‐group differences were noted. Improvement in cardiorespiratory fitness across groups was associated with improved TMT A (unstandardized B = 0.21, p = 0.044), but not TMT B (unstandardized B = 0.002, p = 0.84) or diastolic BP (unstandardized B = ‐0.070, p = 0.58). There were no within‐ or between‐group differences in GCF or systolic BP.ConclusionExercise of high‐ or moderate‐intensity seems to impart modest but positive effects on vascular health and lower‐level cognitive processing. The association between improvements in cardiorespiratory fitness and lower‐level cognition suggest a mechanistic effect. Future research in older adults with hypertension should consider modulating other aspects of exercise training or employ other exercise modalities to benefit cognition.