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The Association of Beta-Blocker Use to Cognitive Impairment among Adults with Hypertension or Cardiovascular Diseases in the United States. 美国成人高血压或心血管疾病患者使用β受体阻滞剂与认知障碍的关系
Chronic pain & management
Pub Date : 2020-01-01 Epub Date: 2020-06-01 DOI: 10.29011/2576-957x.100025
Fnu Safarudin, Chibuzo O Iloabuchi, Amit Ladani, Usha Sambamoorthi

Background: Some studies have shown that beta-blocker use is associated with better cognitive impairment. However, these studies did not control for pain. The relationship between pain and cognitive impairment has been exhaustively investigated. The association of beta blockers to cognitive impairment in the presence of chronic pain is still unknown.

Objective: To examine the independent association of beta-blocker use to cognitive impairment among adults with hypertension or Cardiovascular Diseases (CVDs).

Methods: We used a cross-sectional study design. We derived data on 8,279 adults from the 2015 Medical Expenditure Panel Survey (MEPS). Study participants were adults (age > 21 years), with hypertension or CVDs and without intracranial injury, Parkinson, Alzheimer's disease and Related Dementia. Cognitive impairment was measured based on 1) confusion or memory loss; 2) problems making decisions, or 3) supervision for participant's safety. Anti-hypertensive medications were categorized into 1) beta-blockers; 2) other anti-hypertensives; and 3) no antihypertensive medication. We used multivariable survey logistic regressions to examine the association between beta-blockers and cognitive impairment after controlling for biological factors, pain, chronic conditions, socioeconomic status, access to healthcare services, behavioral, socio-cultural and external environmental factors.

Results: Overall, 24.2%, 41.9%, and 33.9% reported using beta-blockers, other antihypertensives, and no antihypertensive medications, respectively; 18.1% participants reported cognitive impairment. After controlling for pain, beta-blocker use was not significantly associated with cognitive impairment (AOR= 1.22, 95%CI= 1.00-1.49). In fully adjusted models, the AOR for beta-blockers use was 1.05 (95%CI = 0.84-1.31).

Conclusion: In this first large cross-sectional study, we found that the use of beta-blockers was not associated with cognitive impairment. Future prospective studies that include pain management and blood pressure control are needed to confirm the findings.

背景:一些研究表明-受体阻滞剂的使用与较好的认知障碍有关。然而，这些研究并没有控制疼痛。疼痛和认知障碍之间的关系已经得到了详尽的研究。受体阻滞剂与慢性疼痛患者认知障碍的关系尚不清楚。目的:探讨成人高血压或心血管疾病(cvd)患者使用β受体阻滞剂与认知功能障碍的独立关系。方法:采用横断面研究设计。我们从2015年医疗支出小组调查(MEPS)中获得了8279名成年人的数据。研究参与者为成年人(年龄> 21岁)，患有高血压或心血管疾病，无颅内损伤、帕金森、阿尔茨海默病和相关痴呆。认知障碍的测量基于1)思维混乱或记忆丧失;2)决策问题，或3)监督参与者的安全。降压药物分为:1)受体阻滞剂;2)其他抗高血压药物;3)无抗高血压药物。在控制了生物因素、疼痛、慢性疾病、社会经济地位、获得医疗服务、行为、社会文化和外部环境因素后，我们使用多变量调查逻辑回归来检验β受体阻滞剂与认知障碍之间的关系。结果:总体而言，分别有24.2%、41.9%和33.9%的患者报告使用-受体阻滞剂、其他抗高血压药物和未使用抗高血压药物;18.1%的参与者报告有认知障碍。在控制疼痛后，β受体阻滞剂的使用与认知障碍无显著相关性(AOR= 1.22, 95%CI= 1.00-1.49)。在完全调整的模型中，β受体阻滞剂使用的AOR为1.05 (95%CI = 0.84-1.31)。结论:在这第一个大型横断面研究中，我们发现β受体阻滞剂的使用与认知障碍无关。未来的前瞻性研究需要包括疼痛管理和血压控制来证实这些发现。
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引用次数: 3
Application of Auricular Point Acupressure for Pain in Patients with Alzheimer’s Disease and their Caregivers 耳穴按摩在阿尔茨海默病患者及其照护者疼痛中的应用
Chronic pain & management
Pub Date : 2020-01-01 DOI: 10.29011/2576-957x.100031
C. Yeh, Mengchi Li, J. Wenzel, M. Fox, A. Nni, J. Kawi
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引用次数: 0
The Search for Help with a Chronic Pain Problem Can Be Frustrating 寻求慢性疼痛问题的帮助可能会令人沮丧
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-6
B. Sheri
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引用次数: 0
Massage Therapy in the Treatment of Chronic Pain 按摩疗法治疗慢性疼痛
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-18
B. Breakey
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引用次数: 0
Nina: The Use of Potent Opioids in a Complex Chronic Pain Patient 尼娜:强效阿片类药物在复杂慢性疼痛患者中的应用
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-25
M. Margoles
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引用次数: 0
The Many Facets of Chronic Pain 慢性疼痛的许多方面
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-2
M. Margoles, L. A. Funt
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引用次数: 0
Glossary of Terms for Opioids and Opioid-Containing Analgesic Medication in the Management of Chronic Intractable Pain 慢性难治性疼痛的阿片类药物和含阿片类镇痛药物术语表
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-27
M. Margoles
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引用次数: 0
Chronic Pain and Stress 慢性疼痛和压力
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-16
R. Weiner
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引用次数: 0
Chronic Pain Is a Family Problem 慢性疼痛是一个家庭问题
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-5
M. Margoles
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引用次数: 0
When I Control the Pain, I Control My Life: Opioids and Opioid-Containing Analgesic Medication in the Management of Chronic Intractable Pain 当我控制疼痛时，我就控制了我的生活:阿片类药物和含阿片类镇痛药物治疗慢性难治性疼痛
Chronic pain & management
Pub Date : 2019-08-28 DOI: 10.1201/9780367810979-22
M. Margoles
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引用次数: 0
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