High blood pressure treatment may slow cognitive decline

September 5, 2019

Science Daily/American Heart Association

Among middle-aged and older adults, high blood pressure accelerated cognitive decline and treatment slowed the regression. The rate of cognitive decline was similar between adults receiving high blood pressure treatment and those who did not have high blood pressure at all.

High blood pressure appears to accelerate cognitive decline among middle-aged and older adults and treating high blood pressure may slow down the process, according to a preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

The findings are important because high blood pressure and cognitive decline are two of the most common conditions associated with aging, and more people are living longer worldwide.

According to the American Heart Association's 2017 Hypertension Guidelines, high blood pressure is a global health threat, affecting approximately 80 million U.S. adults and one billion people globally. Moreover, the relationship between brain health and high blood pressure is a growing interest as researchers examine how elevated blood pressure affects the brain's blood vessels, which in turn, may impact memory, language and thinking skills.

In this observational study, researchers from Columbia University analyzed data collected on nearly 11,000 adults from the China Health and Retirement Longitudinal Study (CHARLS) between 2011-2015, to assess how high blood pressure and its treatment may influence cognitive decline. High blood pressure was defined as having a systolic blood pressure of 140 mmHg or higher and a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. (Note: The American Heart Association guidelines define high blood pressure as 130 mmHg or higher or a diastolic reading of 80 mmHg or higher.)

Researchers in China interviewed study participants at home about their high blood pressure treatment, education level and noted if they lived in a rural or urban environment. They were also asked to perform cognitive tests, such as immediately recalling words as part of a memory quiz.

Among the study's findings:

Overall cognition scores declined over the four-year study;

Participants ages 55 and older who had high blood pressure showed a more rapid rate of cognitive decline compared with participants who were being treated for high blood pressure and those who did not have high blood pressure; and

The rate of cognitive decline was similar between those receiving high blood pressure treatment and those who did not have high blood pressure.

The study did not evaluate why or how high blood pressure treatments may have contributed to slower cognitive decline or if some treatments were more effective than others.

"We think efforts should be made to expand high blood pressure screenings, especially for at-risk populations, because so many people are not aware that they have high blood pressure that should be treated," said presenting study author Shumin Rui, a biostatistician at the Mailman School of Public Health, Columbia University in New York. "This study focused on middle-aged and older adults in China, however, we believe our results could apply to populations elsewhere as well. We need to better understand how high blood pressure treatments may protect against cognitive decline and look at how high blood pressure and cognitive decline are occurring together."

Novel 5-minute workout improves blood pressure, may boost brain function

April 8, 2019

Science Daily/University of Colorado at Boulder

Could working out five minutes a day, without lifting a single weight or jogging a single step, reduce your heart attack risk, help you think more clearly and boost your sports performance?

Preliminary results from a clinical trial of Inspiratory Muscle Strength Training (IMST), presented this week at the Experimental Biology conference in Orlando, suggest "yes."

"IMST is basically strength-training for the muscles you breathe in with," said Daniel Craighead, a postdoctoral researcher in the the University of Colorado Boulder Integrative Physiology department who is leading the study. "It's something you can do quickly in your home or office, without having to change your clothes, and so far it looks like it is very beneficial to lower blood pressure and possibly boost cognitive and physical performance."

Developed in the 1980s as a means to wean critically ill people off ventilators, IMST involves breathing in vigorously through a hand-held device -- an inspiratory muscle trainer -- which provides resistance. Imagine sucking hard through a straw which sucks back.

During early use in patients with lung diseases, patients performed a 30-minute, low-resistance regimen daily to boost their lung capacity.

But in 2016, University of Arizona researchers published results from a trial to see if just 30 inhalations per day with greater resistance might help sufferers of obstructive sleep apnea, who tend to have weak breathing muscles.

In addition to more restful sleep, subjects showed an unexpected side effect after six weeks: Their systolic blood pressure plummeted by 12 millimeters of mercury. That's about twice as much of a decrease as aerobic exercise can yield and more than many medications deliver.

"That's when we got interested," said principal investigator Professor Doug Seals, director of CU Boulder's Integrative Physiology of Aging Laboratory.

Systolic blood pressure, which signifies the pressure in your vessels when your heart beats, naturally creeps up as arteries stiffen with age, leading to damage of blood-starved tissues and higher risk of heart attack, cognitive decline and kidney damage.

While 30 minutes per day of aerobic exercise has clearly been shown to lower blood pressure, only about 5 percent of adults meet that minimum. Meanwhile, 65 percent of mid-life adults have high systolic blood pressure.

"Our goal is to develop time-efficient, evidence-based interventions that those busy mid-life adults will actually perform," said Seals, who was recently awarded a $450,000 National Institute of Aging grant to fund the clinical trial of IMST involving about 50 subjects.

Craighead presented preliminary results Sunday and Monday at Experimental Biology 2019 showing that:

With about half the tests done, the researchers have found significant drops in blood pressure and improvements in large-artery function among those who performed IMST with no changes in those who used a sham breathing device that delivered low-resistance.

The IMST group is also performing better on certain cognitive and memory tests.

When asked to exercise to exhaustion, they were also able to stay on the treadmill longer and keep their heart rate and oxygen consumption lower during exercise.

Some cyclists and runners have already begun to use commercially-available inspiratory muscle trainers to gain a competitive edge.

But Seals and Craighead stress that their findings are preliminary and curious individuals should ask their doctor before considering IMST.

That said, with a high compliance rate (fewer than 10 percent of study participants drop out) and no real side-effects, they're optimistic.

"High blood pressure is a major risk factor for cardiovascular disease, which is the number one cause of death in America," said Craighead. "Having another option in the toolbox to help prevent it would be a real victory."

https://www.sciencedaily.com/releases/2019/04/190408161643.htm