Cardiorespiratory fitness modifies the relationship between arterial stiffness and cerebral blood flow independent of physical activity

INTRODUCTION

Central arterial stiffness and cerebral blood flow (CBF) are inversely related. Poor cardiorespiratory fitness (CRF) and low physical activity (PA) are related to both higher arterial stiffness and lower CBF. The present study examined (i) whether CRF or PA moderate the relationship between arterial stiffness and CBF, and (ii) whether the intensity or the type of PA needs to be considered.

METHODS

Participants ( N  = 78, Mean _AGE = 64.2±6.14, 72% female) from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center were categorized into low, average, and high fitness groups based on maximal graded exercise treadmill test performance. PA was assessed using the CHAMPS (Community Health Activities Model Program for Seniors) questionnaire. Based on hours/week, participants were classified as meeting the recommended 2.5 h of moderate intensity PA per week (PA Rec Met). Weekly hours of moderate and low intensity PA were calculated as activities of > 3 or < 3 metabolic equivalents, respectively. Activity type was categorized as exercise‐, sports/leisure‐ and work‐related. Arterial stiffness was measured as aortic pulse wave velocity (aoPWV) by 2D phase contrast magnetic resonance imaging (MRI). CBF was assessed by 4D flow MRI in the internal carotid arteries (ICAs), cavernous ICAs, middle cerebral arteries (MCAs), and via two composite measures of total and global flow.

RESULTS

The association between aoPWV and CBF differed by fitness levels, with a negative relationship in the low fitness group and positive relationships in the average and high fitness groups (all P s<0.05). Significant moderating effects on the relationships between aoPWV and CBF were also observed for PA Rec Met (all P s<0.05), moderate intensity ( p  = 0.05), and exercise‐related (all p’ s < 0.02) PA.

DISCUSSION

Average or high fitness, meeting the PA guidelines, and more specifically, moderate intensity and exercise‐related PA seem to attenuate the negative relationship between aoPWV on CBF.

Highlights

• Higher cardiorespiratory fitness (CRF) reduces the negative impact of aortic pulse wave velocity (aoPWV) on cerebral blood flow (CBF)

• 150 min of moderate physical activity (PA) also mitigates this impact, depending on activity type

• Innovative methods: use of cardiac magnetic resonance imaging (MRI) for aoPWV assessment

• Innovative methods: use of free‐breathing acquisition during cardiac MRI

• Innovative methods: use of cranial 4D flow MRI for CBF assessment