Limitations and future research
white matter lesions
ELEVATED BLOOD PRESSURE, EVENT, HIGH BLOOD PRESSURE
Despite our comprehensive inclusion and exclusion criteria, our cohort of young adults with elevated blood pressure might have had considerable heterogeneity in the cause and duration of their high blood pressure. Some of the variation in vessel size could relate to heterogeneity in risk factors between participants induced by the exercise intervention and a larger study will be able to explore in subgroups with different risk factors. Specifically, adults born preterm have a unique cardiac phenotype (Since the CBF images were registered to a brain template for voxel-wise analyses, these analyses could be affected by registration errors. Nevertheless, the results could only have been caused by a registration error if the amount of increase in ICA lumen diameter in response to an exercise intervention was associated with the registration to the average template. The study was also performed in young people and therefore long term follow up with clinical event rates is not feasible. A longitudinal follow-up study could investigate if changes in vascular lumen diameter and blood flow and volume in the exercise intervention group remained over time. Research remains to be done to establish the optimal exercise type, dose, and duration to protect brain health in young adults with elevated blood pressure and whether resting CBF can be changed through exercise. A follow-up study could also examine the effect of exercise on white matter lesions. The intervention period was too short to be able to observe group differences in lesion changes in this study.