Y. Zhu, C. Li, D. Gao, X. Huang, Y. Zhang, M. Ji, Fanfan Zheng, Wuxiang Xie
{"title":"血压轨迹与后续认知能力下降、痴呆症和死亡率的关系","authors":"Y. Zhu, C. Li, D. Gao, X. Huang, Y. Zhang, M. Ji, Fanfan Zheng, Wuxiang Xie","doi":"10.14283/jpad.2024.91","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To examine long-term BP trajectories in relation to subsequent cognitive decline, incident dementia and all-cause mortality in the general population.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>Population-based cohort study.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>Communities in England.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>The study included 7566 participants from the English Longitudinal Study of Ageing (ELSA).</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>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.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"23 1","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of Blood Pressure Trajectories with Subsequent Cognitive Decline, Dementia and Mortality\",\"authors\":\"Y. Zhu, C. Li, D. Gao, X. Huang, Y. Zhang, M. Ji, Fanfan Zheng, Wuxiang Xie\",\"doi\":\"10.14283/jpad.2024.91\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Objectives</h3><p>To examine long-term BP trajectories in relation to subsequent cognitive decline, incident dementia and all-cause mortality in the general population.</p><h3 data-test=\\\"abstract-sub-heading\\\">Design</h3><p>Population-based cohort study.</p><h3 data-test=\\\"abstract-sub-heading\\\">Setting</h3><p>Communities in England.</p><h3 data-test=\\\"abstract-sub-heading\\\">Participants</h3><p>The study included 7566 participants from the English Longitudinal Study of Ageing (ELSA).</p><h3 data-test=\\\"abstract-sub-heading\\\">Measurements</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>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). 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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.
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.