Physical Fitness, Cardiovascular and Brain Health

Study Overview
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Brief Summary
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The goal of this study is to determine if aerobic exercise or progressive muscle relaxation is associated with changes in cardiovascular health, brain function, and cognition.

Detailed Description
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Cognition is the most important determinant of health status, quality of life and functional ability in older age. Therefore, early interventions that preserve and enhance cognitive function are crucial for ensuring successful aging. The most common treatable risk factor for late-life cognitive impairment is midlife hypertension (HTN). One highly promising intervention strategy is aerobic exercise as it has been associated cognitive benefits in non-demented older adults. However, it is still unclear whether this benefit is due simply to prevention of other risk factors (e.g., reductions in blood pressure) or if exercise can reverse the negative effects of HTN on the brain. The goals of the current study are to employ sensitive measures of neuroimaging and cognition in order to 1).Compare cerebral health in endurance trained versus sedentary middle aged adults with normal or borderline to stage 1 hypertension, 2). measure the effects of exercise training in previously sedentary middle aged adults adults with normal or borderline to stage 1 hypertension, and 3). examine if exercise-related differences and changes in neural integrity and cognition are mediated by systemic vascular health.

Official Title
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Physical Fitness, Cardiovascular and Brain Health

Conditions
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Hypertension

Intervention / Treatment
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* Behavioral: Aerobic Exercise
* Behavioral: Relaxation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Sedentary adults Participants will be classified as sedentary if they have not engaged in regular physical exercise for at least one year prior to study enrollment. Ages 45-65 Normal blood pressure or Borderline or stage 1 hypertension Borderline hypertension will be defined as systolic blood pressure between 120-139 mmHg and/or diastolic blood pressure between 80-89 mmHg. Stage 1 hypertension will be defined as systolic blood pressure between 140-159 mmHg and/or diastolic blood pressure between 90-99 mmHg. Exclusion Criteria: Signs or symptoms of chronic heart disease Smoking (current or within the past 6 months) Peripheral artery disease (ankle-brachial index<0.9) Diabetes (fasting blood glucose>126 mg/L) Orthopedic problems that would prohibit participants from participating in exercise. Axis I psychiatric disorder Magnetic resonance contraindications Baseline Intellectual Quotient < 70 Below chance performance on the practice items of the cognitive tasks Evidence of large vessel stroke on magnetic resonance imaging

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Aerobic Exersice<br>12-week moderate aerobic exercise program | Behavioral: Aerobic Exercise<br>* 12-week moderate-intensity aerobic exercise program designed in accordance with the recommended guidelines established by the American College of Sports Medicine<br>* Other names: Exercise;|
| Active Comparator: Relaxation<br>12-week at home progressive muscle relaxation program | Behavioral: Relaxation<br>* 12-week progressive muscle relaxation program (active control)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent signal change in Blood oxygen level-dependent (BOLD) response to a working memory task | Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) during 2-Back working memory task | change from baseline in blood oxygen level-dependent (BOLD) response to WM task at 14 weeks | 
| N-acetyl aspartate (NAA) concentration | Magnetic resonance spectroscopy (MRS) measurements of N-acetyl-aspartate (NAA) | change from baseline in N-acetyl aspartate (NAA) concentration at 14 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hypertension, aerobic exercise, relaxation, functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), brain health