Background: Resistant hypertension is associated with increased risk of cognitive decline, stroke, and dementia. Lifestyle modification has been suggested to improve cognitive function through its salutary effects on vascular function.
Methods: Participants included 140 patients with resistant hypertension participating in the TRIUMPH trial. Participants were randomized to a cardiac rehabilitationbased lifestyle program (C-LIFE) or a standardized education and physician advice condition (SEPA). Participants completed a 45-min cognitive test battery consisting of tests of Executive Functioning and Learning, Memory, and Processing Speed. Biomarkers of vascular [flow mediated dilation of the brachial artery (FMD)], microvascular, and cerebrovascular function were also collected, in addition to weight, fitness, and ambulatory blood pressure.Results: Participants averaged 63 years of age, 48% women, 59% black, and obese [mean BMI ¼ 36 kg/m 2 (SD ¼ 4)]. Cognitive performance improved across the entire cohort during the 4-month trial [t-scores pretreatment ¼ 48.9 (48, 50) vs. posttreatment ¼ 50.0 (49, 51), P < 0.001]. Postintervention Executive Function/ Learning composite performance was higher for participants in C-LIFE compared to SEPA (d ¼ 0.37, P ¼ 0.039). C-LIFE intervention effects on Memory and Processing Speed were moderated by sex and baseline stroke risk, respectively (P ¼ 0.026 and P ¼ 0.043 for interactions), such that males and participants with greater stroke risk showed the greatest cognitive changes. FMD
There is a lack of knowledge on the intersection between prematurity, small for gestational age, and hypertensive disorders of pregnancy (HDP). Therefore, the aim of this systematic review was to examine the outcomes of preterm infants who were small for gestational age born to women with HDP. Searches were conducted with no date restriction through the final search date of May 13, 2020, in the following databases: PubMed, Web of Science Core Collection, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (EBSCOhost), and Embase (Elsevier). A total of 6 studies were eligible for this review. The adjusted odds of mortality and necrotizing
Objective:
To compare the health, physical growth, and developmental outcomes in preterm infants of women with and without hypertensive disorders of pregnancy (HDP).
Design:
Cross-sectional analysis of health outcomes; physical growth (head circumference, height, and weight) collected at birth and 2 months corrected for prematurity; and cognitive, language, and motor skills of preterm infants of women with and without HDP.
Setting:
Four NICUs in the United States.
Participants:
Women (n=221) and their preterm infants who weighed less than 1750g were enrolled in a multicenter, randomized trial of two interventions administered by the infant’s mother when the infants were no longer critically ill.
Methods:
Women and their preterm infants were categorized into groups with (n=80) and without (control, n=141) HDP. Data were extracted from infant medical records, and the women completed questionnaires.
Results:
The infants of women with HDP were more likely to be small for gestational age than the infants of women without HDP (31.7% versus 10.6%, p<0.002). The proportion of infants with high neurological risk, patent ductus arteriosus, intraventricular hemorrhage, and days on a ventilator did not differ between the groups. Although infants’ height at 2 months was lower in the HDP group than the control group, other growth and neurodevelopmental outcomes did not differ between the groups.
Conclusion:
Among preterm infants admitted to the NICU, those born to women with HDP were more likely to be small for gestational age than those of normotensive women. Additional research is needed to optimize care for infants born to women with HDP.
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