Skip to main content

Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial.

Publication ,  Journal Article
Smith, PJ; Sherwood, A; Hinderliter, AL; Mabe, S; Watkins, LL; Craighead, L; Ingle, K; Tyson, C; Avorgbedor, F; Lin, P-H; Kraus, WE; Liao, L ...
Published in: J Hypertens
July 1, 2022

BACKGROUND: Resistant hypertension is associated with increased risk of cognitive decline, stroke, and dementia. Lifestyle modification has been suggested to improve cognitive function through its salutary effects on vascular function. METHODS: Participants included 140 patients with resistant hypertension participating in the TRIUMPH trial. Participants were randomized to a cardiac rehabilitation-based lifestyle program (C-LIFE) or a standardized education and physician advice condition (SEPA). Participants completed a 45-min cognitive test battery consisting of tests of Executive Functioning and Learning, Memory, and Processing Speed. Biomarkers of vascular [flow mediated dilation of the brachial artery (FMD)], microvascular, and cerebrovascular function were also collected, in addition to weight, fitness, and ambulatory blood pressure. RESULTS: Participants averaged 63 years of age, 48% women, 59% black, and obese [mean BMI = 36 kg/m 2 (SD = 4)]. Cognitive performance improved across the entire cohort during the 4-month trial [ t -scores pretreatment = 48.9 (48, 50) vs. posttreatment = 50.0 (49, 51), P  < 0.001]. Postintervention Executive Function/Learning composite performance was higher for participants in C-LIFE compared to SEPA ( d  = 0.37, P  = 0.039). C-LIFE intervention effects on Memory and Processing Speed were moderated by sex and baseline stroke risk, respectively ( P  = 0.026 and P  = 0.043 for interactions), such that males and participants with greater stroke risk showed the greatest cognitive changes. FMD [C-LIFE: +0.3% (-0.3, 1.0) vs. SEPA: -1.4% (-2.5, -0.3), P  = 0.022], and microvascular function [C-LIFE: 97 (65, 130) vs. SEPA: 025 (-75, 23), P  < 0.001] were improved in C-LIFE compared with SEPA, whereas cerebrovascular reactivity was not [C-LIFE: -0.2 (-0.4, 0) vs. SEPA: 0.1 (-0.2, 0.4), P  = 0.197). Mediation analyses suggested that increased executive function/learning was associated with reduced ambulatory SBP levels secondary to weight loss [indirect effect: B  = 0.25 (0.03, 0.71)]. CONCLUSION: Lifestyle modification individuals with resistant hypertension improves cognition, which appeared to be associated with reduced ambulatory SBP changes through weight loss. Cognitive improvements were accompanied by parallel improvements in endothelial and microvascular function.

Duke Scholars

Published In

J Hypertens

DOI

EISSN

1473-5598

Publication Date

July 1, 2022

Volume

40

Issue

7

Start / End Page

1359 / 1368

Location

Netherlands

Related Subject Headings

  • Weight Loss
  • Stroke
  • Male
  • Life Style
  • Hypertension
  • Humans
  • Female
  • Cognitive Dysfunction
  • Cognition
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Smith, P. J., Sherwood, A., Hinderliter, A. L., Mabe, S., Watkins, L. L., Craighead, L., … Blumenthal, J. A. (2022). Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial. J Hypertens, 40(7), 1359–1368. https://doi.org/10.1097/HJH.0000000000003151
Smith, Patrick J., Andrew Sherwood, Alan L. Hinderliter, Stephanie Mabe, Lana L. Watkins, Linda Craighead, Krista Ingle, et al. “Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial.J Hypertens 40, no. 7 (July 1, 2022): 1359–68. https://doi.org/10.1097/HJH.0000000000003151.
Smith PJ, Sherwood A, Hinderliter AL, Mabe S, Watkins LL, Craighead L, et al. Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial. J Hypertens. 2022 Jul 1;40(7):1359–68.
Smith, Patrick J., et al. “Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial.J Hypertens, vol. 40, no. 7, July 2022, pp. 1359–68. Pubmed, doi:10.1097/HJH.0000000000003151.
Smith PJ, Sherwood A, Hinderliter AL, Mabe S, Watkins LL, Craighead L, Ingle K, Tyson C, Avorgbedor F, Lin P-H, Kraus WE, Liao L, Blumenthal JA. Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial. J Hypertens. 2022 Jul 1;40(7):1359–1368.

Published In

J Hypertens

DOI

EISSN

1473-5598

Publication Date

July 1, 2022

Volume

40

Issue

7

Start / End Page

1359 / 1368

Location

Netherlands

Related Subject Headings

  • Weight Loss
  • Stroke
  • Male
  • Life Style
  • Hypertension
  • Humans
  • Female
  • Cognitive Dysfunction
  • Cognition
  • Cardiovascular System & Hematology