The Impact of Blood Pressure Dipping Status on Cognition, Mobility, and Cardiovascular Health in Older Adults Following an Exercise Program

Narlon C Boa Sorte Silva, Michael A Gregory, Dawn P Gill, Cheri L McGowan, Robert J Petrella, Narlon C Boa Sorte Silva, Michael A Gregory, Dawn P Gill, Cheri L McGowan, Robert J Petrella

Abstract

Objectives: To determine whether a dual-task gait and aerobic exercise intervention differentially impacted older adults with normal blood pressure (BP) dipping status (dippers) compared to those with nondipping status (nondippers). Methods: This study was a secondary analysis involving participants (mean age = 70.3 years, 61% women) who attended a laboratory-based exercise intervention over a 6-month period (40 min/day and 3 days/week). Participants were assessed in measures of cognition, mobility, and cardiovascular health at baseline, 3, 6, and 12 months (after a 6-month no-contact follow-up). Results: We observed improvements in cognition in both groups at 6 and 12 months, although no between-group differences were seen. Nondippers demonstrated superior improvements in usual gait velocity and step length after the exercise intervention compared to dippers. Dippers reduced daytime systolic BP at 6 and 12 months to a greater extent than nondippers. Discussion: BP dipping status at baseline did not influence exercise benefits to cognition but did mediate changes in mobility and cardiovascular health.

Keywords: aging; blood pressure; cognition; exercise; mobility.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Participant flow for the 6-month case-series study with a 6-month no-contact follow-up.
Figure 2.
Figure 2.
Estimated mean changes in cognition. Note. Solid triangles (nondippers) and squares (dippers) represent estimated group mean changes from baseline; bars represent associated 95% confidence intervals. Confidence intervals not including zero (i.e., not crossing the vertical dotted line) indicate significant differences from baseline (see Supplemental Table 1). All analyses were adjusted for age, education, gender, presence of hypertension, and type 2 diabetes.
Figure 3.
Figure 3.
Estimated mean changes in mobility. Note. Solid triangles (nondippers) and squares (dippers) represent estimated group mean changes from baseline; bars represent associated 95% confidence intervals. Confidence intervals not including zero (i.e., not crossing the vertical dotted line) indicate significant differences from baseline (see Supplemental Table 1). The p value indicates significant differences between groups in estimated mean change from baseline adjusting for age, education, gender, presence of hypertension, and type 2 diabetes.
Figure 4.
Figure 4.
Estimated mean changes in cardiovascular health from baseline. Note. Solid triangles (nondippers) and squares (dippers) represent estimated group mean changes from baseline; bars represent associated 95% confidence intervals. Confidence intervals not including zero (i.e., not crossing the vertical dotted line) indicate significant differences from baseline (see Supplemental Table 1). The p value indicate significant differences between groups in estimated mean change from baseline adjusting for age, education, gender, presence of hypertension, and type 2 diabetes.

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