title: Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later.
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).
  
  
  CONCLUSIONS
  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.
authors: 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.
authors: Nicole L
authors: NL
authors: Spartano
authors: 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.
authors: Jayandra J
authors: JJ
authors: Himali
authors: 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.
authors: Alexa S
authors: AS
authors: Beiser
authors: 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.
authors: Gregory D
authors: GD
authors: Lewis
authors: 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.
authors: Charles
authors: C
authors: DeCarli
authors: 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.
authors: Ramachandran S
authors: RS
authors: Vasan
authors: 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.
authors: Sudha
authors: S
authors: Seshadri
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D054022:Cerebrum / Q000033:anatomy & histology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*