Anchoring Protein Increases Cerebrovascular Responses and Blood Pressure During Hypertension: Turn Round Quick and Start to Run

The World Health Organization estimates 1.4 billion adults have hypertension globally. 1he brain and its vasculature are among the most affected end-organs, with changes that include dysregulation of cerebral blood flow (CBF), atherosclerosis, vascular remodeling, and increased wall stiffness of aorta and larger arteries.Hypertension is a major risk factor for cerebrovascular disease and downstream consequences.Such effects include chronic reductions in CBF, overt ischemic and hemorrhagic strokes, covert strokes due to small vessel disease, loss of cognitive reserve, and mild cognitive impairment (Figure).In some individuals, mild cognitive impairment progresses over time to dementias. 2Hypertension interacts with other risk factors.For example, reductions in CBF with normal aging are increased when combined with hypertension. 3,4ile hypertension is the leading modifiable risk factor, 2,5,6 lack of physical activity, sometimes termed sedentary behavior, is also a risk factor for cerebrovascular disease, strokes, and other effects related to brain health. 5,7,8Increased physical activity is associated with reduced risk for cognitive decline and all-cause dementia. 8Mechanisms that underlie such effects are not well defined, but contributors may include reductions in blood pressure and the vascular contribution to cognitive deficits and dementias. 6,8An analysis of multiple Alzheimer's disease and exercise data sets predicted exercise may be the most effective treatment for dementia, one with the potential to even reverse features of Alzheimer's disease.