Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure.
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High blood pressure increases the risks of stroke, dementia, and neurocognitive dysfunction. Although aerobic exercise and dietary modifications have been shown to reduce blood pressure, no randomized trials have examined the effects of aerobic exercise combined with dietary modification on neurocognitive functioning in individuals with high blood pressure (ie, prehypertension and stage 1 hypertension). As part of a larger investigation, 124 participants with elevated blood pressure (systolic blood pressure 130 to 159 mm Hg or diastolic blood pressure 85 to 99 mm Hg) who were sedentary and overweight or obese (body mass index: 25 to 40 kg/m(2)) were randomized to the Dietary Approaches to Stop Hypertension (DASH) diet alone, DASH combined with a behavioral weight management program including exercise and caloric restriction, or a usual diet control group. Participants completed a battery of neurocognitive tests of executive function-memory-learning and psychomotor speed at baseline and again after the 4-month intervention. Participants on the DASH diet combined with a behavioral weight management program exhibited greater improvements in executive function-memory-learning (Cohen's D=0.562; P=0.008) and psychomotor speed (Cohen's D=0.480; P=0.023), and DASH diet alone participants exhibited better psychomotor speed (Cohen's D=0.440; P=0.036) compared with the usual diet control. Neurocognitive improvements appeared to be mediated by increased aerobic fitness and weight loss. Also, participants with greater intima-medial thickness and higher systolic blood pressure showed greater improvements in executive function-memory-learning in the group on the DASH diet combined with a behavioral weight management program. In conclusion, combining aerobic exercise with the DASH diet and caloric restriction improves neurocognitive function among sedentary and overweight/obese individuals with prehypertension and hypertension.
Blood Pressure Determination
Body Mass Index
Combined Modality Therapy
Quality of Life
Severity of Illness Index
Published Version (Please cite this version)10.1161/HYPERTENSIONAHA.109.146795
Publication InfoBabyak, MA; Blumenthal, James Alan; Browndyke, Jeffrey Nicholas; Craighead, Linda W; Sherwood, Andrew; Smith, Patrick J; ... Welsh-Bohmer, Kathleen Anne (2010). Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension, 55(6). pp. 1331-1338. 10.1161/HYPERTENSIONAHA.109.146795. Retrieved from http://hdl.handle.net/10161/13856.
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J. P. Gibbons Professor of Psychiatry I
Psychosocial factors and coronary heart disease, including such factors as social support, Type A behavior and hostility, and depression, exercise training and depression in the elderly; behavioral approaches to the treatment of hypertension (e.g., weight loss and exercise); cardiac rehabilitation; neuropsychological outcomes following cardiac surgery; psychosocial aspects of heart and lung transplantation; exercise training and osteoarthritis and fibromyalgia; compliance.
Associate Professor in Psychiatry and Behavioral Sciences
Dr. Browndyke is an Associate Professor of Geriatric Behavioral Health in the Department of Psychiatry & Behavioral Sciences. He also holds affiliate faculty appointments with the Duke Brain Imaging & Analysis Center (BIAC), Duke Institute for Brain Science (DIBS), Center for Cognitive Neuroscience (CCN), and the Duke Center for Geriatric Surgery. He has dual appointment to the Duke University Medical Center and the Durham VA Medical Center, the latter of which is where his c
Professor in Psychiatry and Behavioral Sciences
My current research focus is on biological, behavioral and sociocultural factors involved in the etiology and management of hypertension, coronary artery disease, and congestive heart failure. The role of stress and the sympathetic nervous system in disease onset and progression is of central interest. Current research issues being studied include: (i) Ethnicity and gender as factors related to the pathogenesis of hypertension; (ii) Mechanisms by which menopause increases the risk of card
Associate Professor in Psychiatry and Behavioral Sciences
Dr. Smith is interested in the impact of lifestyle interventions, such as diet and exercise, on neurocognitive function and mood. He has also published multiple studies examining the relationship between cardiovascular disease, major depressive disorder, and neurocognitive outcomes, preoperative predictors of postoperative delirium, the impact of cardiothoracic interventions on neurocognitive outcomes, and the relationship between patterns of dietary intake and cardiovascular outcomes. He is als
Professor of Psychology and Neuroscience
Professor Strauman's research focuses on the psychological and neurobiological processes that enable self-regulation, conceptualized in terms of a cognitive/motivational perspective, as well as the relation between self-regulation and affect. Particular areas of emphasis include: (1) conceptualizing self-regulation in terms of brain/behavior motivational systems; (2) the role of self-regulatory cognitive processes in vulnerability to depression and other disorders; (3) the impact of tre
Professor of Psychiatry and Behavioral Sciences
Dr. Kathleen Welsh-Bohmer is a Professor of Psychiatry with a secondary appointment in the Department of Neurology. She is also the Chief of the Medical Psychology CPU, the professional home for the over 200 academic psychologists within Duke Medical Center. Clinically trained as a neuropsychologist, Dr. Welsh-Bohmer's research activities have been focused around developing effective prevention and treatment strategies to delay the onset of
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