在患有心脏代谢性疾病的老年门诊患者中,血压和认知障碍之间的关系
Joji Ishikawa1, Ayumi Toba1, Yoshiaki Tamura2
1Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Geriatrics & gerontology international
|November 7, 2023
概括
血压影响心脏病老年人的认知功能. 低缩血压与高血压患者的认知能力下降有关,而高血压与非高血压患者的痴呆风险有关.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 心脏代谢性疾病对老年人群的健康和福祉产生重大影响.
- 血压 (BP) 是心血管健康的关键因素,并与认知功能有关.
- 了解BP与认知之间的复杂关系对于管理与年龄相关的认知衰退至关重要.
研究的目的:
- 为了研究高血压或低血压 (BP) 与心脏代谢疾病的老年门诊患者的认知功能之间的关联.
- 根据高血压病史和治疗状态来区分血压-认知关系.
主要方法:
- 评估了677名患有心脏代谢疾病的老年门诊患者的队列.
- 用社区综合护理系统-21项 (DASC-21),迷你精神状态检查 (MMSE) 和蒙特利尔认知评估工具 (MoCA) 的痴呆症评估表来测量血压,并评估认知功能.
- 统计分析包括线性和后勤回归来确定BP和认知得分之间的关联,控制混因素.
主要成果:
- 系统性血压 (SBP) 与DASC-21得分呈现线性关系 (r = -0.122,P = 0.004).
- 较低的SBP与DASC-21的较差表现显著相关,即使经过对混因子进行调整 (B = -0.411每10mmHg,P = 0.002).
- 在没有高血压病史的患者中,MMSE得分≤23与较高的SBP有关,但在高血压患者,服用高血压药物或患有失脂症患者中降低SBP.
结论:
- 高血压与在没有高血压病史的老年人中可能患有痴呆症的更大患病率有关.
- 在高血压患者中,特别是那些服用药物和并发症的患者中,较低的血压与可能的痴呆症有关,通常与日常生活活动减少有关 (DASC-21).
- 这些发现突显出高血压和心脏代谢疾病的老年人认知状态之间的复杂,双向关系,强调需要个性化高血压管理策略.
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