在SPRINT-MIND之后,血管认知障碍的临床试验:国际视角
Fanny M Elahi1, Suvarna Alladi2, Sandra E Black3
1Friedman Brain Institute, Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Cell reports. Medicine
|June 21, 2023
概括
在老年人中,强化血压控制显著降低了认知障碍的风险. 这表明,在全球老龄化人口中预防痴呆症的成本有效策略.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 系统性血压干预试验子研究 (SPRINT-MIND) 调查了与血压目标相关的认知结果.
- 认知障碍和痴呆症带来了重大的公共卫生挑战,特别是在老年人群中.
研究的目的:
- 讨论关键问题,并为SPRINT-MIND试验后的临床实践和未来研究提供建议.
- 探索密集降低血压以缓解认知衰退的潜力.
主要方法:
- 分析了SPRINT-MIND试验的发现,比较了密集的 (静脉压<120 mm Hg) 与标准的 (静脉压<140 mm Hg) 血压目标.
- 对临床实践和试验设计的影响进行基于视角的讨论.
主要成果:
- 强烈降低血压与老年人认知障碍风险降低有关.
- 没有一种特定的抗高血压药物类别在降低痴呆风险方面表现出优越性.
结论:
- 强化降低血压可能是一个具有成本效益的方法来降低不同,老龄化人口的痴呆风险.
- 未来的试验应纳入适当的认知终点,适应性设计,多样化的人口 (包括老年人) 和新的生物标志物.
- 结合生活方式变化和药物治疗的多领域干预措施可能会对认知健康产生最大的影响.
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