Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure

• Type of Material: Article
• Authors: Patrick J. Smith, Duke University Medical Center; James A. Blumenthal, Duke University Medical Center; Michael A. Babyak, Duke University Medical Center; Linda Craighead, Emory University; Kathleen A. Welsh-Bohmer, Duke University Medical Center; Jeffrey N. Browndyke, Duke University Medical Center; Timothy A. Strauman, Duke University; Andrew Sherwood, Duke University Medical Center
• Language: English
• Date: 2010-06-01
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.146795
• Title of Journal or Parent Work: Hypertension
• ISSN: 0194-911X
• Volume: 55
• Issue: 6
• Start Page: 1331
• End Page: 1338
• Grant/Funding Information: This publication was made possible by grant number 5UL1RR024128-03 from the National Center for Research Resources (NCRR), a component of the NIH; and NIH Roadmap for Medical Research.; This work was supported by grants from the National Heart, Lung, and Blood Institute (HL074103) and the General Clinical Research Center, National Institutes of Health (NIH) (M01-RR-30).
• Keywords: Reference Values; Neuropsychological Tests; Follow-Up Studies; Risk Assessment; Hypertension; Exercise; Diet, Reducing; Cognition Disorders; Probability; Overweight; Humans; Feeding Behavior; Caloric Restriction; Blood Pressure Determination; Male; Middle Aged; Quality of Life; Severity of Illness Index; Body Mass Index; Behavior Therapy; Combined Modality Therapy; Executive Function; Treatment Outcome; Linear Models; Female
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Nutrition; Psychology, Behavioral

Abstract

High blood pressure increases the risks of stroke, dementia, and neurocognitive dysfunction. Although aerobic exercise and dietary modifications have been shown to reduce blood pressure, no randomized trials have examined the effects of aerobic exercise combined with dietary modification on neurocognitive functioning in individuals with high blood pressure (ie, prehypertension and stage 1 hypertension). As part of a larger investigation, 124 participants with elevated blood pressure (systolic blood pressure 130 to 159 mm Hg or diastolic blood pressure 85 to 99 mm Hg) who were sedentary and overweight or obese (body mass index: 25 to 40 kg/m) were randomized to the Dietary Approaches to Stop Hypertension (DASH) diet alone, DASH combined with a behavioral weight management program including exercise and caloric restriction, or a usual diet control group. Participants completed a battery of neurocognitive tests of executive function-memory-learning and psychomotor speed at baseline and again after the 4-month intervention. Participants on the DASH diet combined with a behavioral weight management program exhibited greater improvements in executive function-memory-learning (Cohen's D=0.562; P=0.008) and psychomotor speed (Cohen's D=0.480; P=0.023), and DASH diet alone participants exhibited better psychomotor speed (Cohen's D=0.440; P=0.036) compared with the usual diet control. Neurocognitive improvements appeared to be mediated by increased aerobic fitness and weight loss. Also, participants with greater intima-medial thickness and higher systolic blood pressure showed greater improvements in executive function-memory-learning in the group on the DASH diet combined with a behavioral weight management program. In conclusion, combining aerobic exercise with the DASH diet and caloric restriction improves neurocognitive function among sedentary and overweight/obese individuals with prehypertension and hypertension.