血压轨迹与后续认知能力下降、痴呆症和死亡率的关系

Y. Zhu, C. Li, D. Gao, X. Huang, Y. Zhang, M. Ji, Fanfan Zheng, Wuxiang Xie
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引用次数: 0

摘要

背景高血压可能会损害认知能力,但血压(BP)的纵向模式,尤其是舒张压(DBP)与认知能力的潜在相关性尚不清楚。目的研究普通人群中长期血压轨迹与随后的认知能力下降、痴呆症和全因死亡率的关系。采用基于群体的轨迹模型来确定收缩压 (SBP) 和 DBP 的长期模式。结果SBP和DBP分别有五种不同的轨迹。以正常稳定的轨迹为参照。在认知能力下降方面,SBP 和 DBP 轨迹均与随后的认知能力下降独立相关,其中下降最快的是 180 mmHg 的高稳定 SBP 组和 60 mmHg 的低稳定 DBP 组(P<0.005)。在所有 SBP 轨迹中,高稳定组发生痴呆的多变量调整危险比(HR)也最大(4.79,95% 置信区间:2.84 至 8.07)。相反,低(HR:1.58)和中低稳定(HR:1.56)DBP轨迹会增加痴呆风险(P<0.005)。结论我们的研究评估了不同血压轨迹对健康的潜在影响,并表明控制长期的 SBP 和保持足够的 DBP 可能与当前促进认知健康和延长寿命的实践相关。
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Associations of Blood Pressure Trajectories with Subsequent Cognitive Decline, Dementia and Mortality

Background

Hypertension may harm cognitive performance, but the potential correlates of longitudinal patterns of blood pressure (BP), especially diastolic BP (DBP), to cognition have been unclear.

Objectives

To examine long-term BP trajectories in relation to subsequent cognitive decline, incident dementia and all-cause mortality in the general population.

Design

Population-based cohort study.

Setting

Communities in England.

Participants

The study included 7566 participants from the English Longitudinal Study of Ageing (ELSA).

Measurements

BP were measured in 1998, 2004, 2008. Group-based trajectory modeling was used to identify longterm patterns of systolic BP (SBP) and DBP. Outcomes including cognitive function, incident dementia, and all-cause mortality were followed up to 10 years.

Results

Five distinct trajectories were identified for SBP and DBP, respectively. The normal-stable trajectory was used as the reference. For cognitive decline, both SBP and DBP trajectories were independently associated with subsequent cognitive decline, with the fastest decline appeared in the high-stable SBP group of 180 mmHg and the low-stable DBP group of 60 mmHg (both P<0.005). For incident dementia, the multivariable adjusted hazard ratio (HR) was also greatest in high-stable group (4.79, 95% confidence interval: 2.84 to 8.07) across all SBP trajectories. Conversely, low (HR: 1.58) and moderate-low stable (HR: 1.56) DBP trajectories increased dementia risk (both P<0.005). Similar patterns were found in BP trajectories in relation to all-cause mortality.

Conclusion

Our study evaluates the potential health impact from different BP trajectories and suggests that controlling long-term SBP and maintaining adequate DBP may be relevant for the current practice to promote cognitive health and extend lifespan.

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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
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期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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