密集与标准血压控制对可能痴呆的影响:随机临床试验
, Jeff D Williamson1, Nicholas M Pajewski2
1Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
JAMA
|January 29, 2019
概括
强化血压控制并没有显著降低痴呆风险. 然而,它降低了高血压成年人的轻度认知障碍和综合认知衰退的风险.
科学领域:
- 神经学
- 心脏病学
- 老年病学
背景情况:
- 目前还没有经过验证的治疗方法来降低轻度认知障碍和痴呆的风险.
- 高血压是一种可改变的认知衰退风险因素.
研究的目的:
- 评估密集血压控制对痴呆风险的影响.
主要方法:
- 一项随机临床试验,涉及50岁以上的9361名高血压患者.
- 参与者被随机分配到静脉压目标< 120 mm Hg (强度) 或< 140 mm Hg (标准).
- 认知结果包括可能的痴呆症和轻度认知障碍.
主要成果:
- 密集的血压控制没有显著降低可能的痴呆风险 (HR,0. 83;95% CI,0. 67-1. 04).
- 密集控制显著降低了轻度认知障碍的风险 (HR,0. 81;95% CI,0. 69- 0. 95).
- 轻度认知障碍或可能的痴呆症的综合结果也减少了 (HR,0. 85;95% CI,0. 74- 0. 97).
结论:
- 与< 140mmHg相比,治疗以静脉压目标< 120mmHg并没有显著降低可能的痴呆风险.
- 这项研究可能不足以检测由于早期终止和比预期更少的病例导致的痴呆风险的显著差异.
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