抗高血压药物和老年人患有高血压的痴呆症
Suzanne G Orchard1, Zhen Zhou1,2, Michelle Fravel3
1School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
medRxiv : the preprint server for health sciences
|September 10, 2024
概括
某些血压药物可能会影响老年人的痴呆风险. ангиотензин受体阻断剂和β-阻断剂似乎可以降低痴呆症的风险,与ACE抑制剂和利尿剂不同.
科学领域:
- 老年学是指老年学的学科.
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 众所周知,密集的血压控制可以减少认知能力下降.
- 抗高血压药物 (AHM) 类别对痴呆风险的差异性影响,独立于降血压 (BP) 功效,在老年人中仍然不清楚.
研究的目的:
- 研究不同类型的抗高血压药物 (AHM) 与社区居住的高血压老年人中发生痴呆症的风险之间的关联.
主要方法:
- 对ASPREE随机试验进行了后期分析.
- 考克斯的比例风险回归模型评估了70岁以上高血压参与者的AHM暴露和事件痴呆症.
- 小组分析探讨了诸如APOE ε4载体状态和单一治疗等因素.
主要成果:
- 总体而言,使用AHM与痴呆症风险降低无关 (HR 0.84,95%CI 0.70-1.02).
- ангиотензин受体阻断剂 (ARB) 和β阻断剂与痴呆风险降低有关 (HR 0.73, 95%CI 0.59-0.92对于ARB).
- ангиотензин转化酶抑制剂 (ACEI) 和利尿药与痴呆症风险增加有关.
结论:
- 特定的AHM类别对老年人痴呆风险有不同的影响.
- 与ACEI和利尿剂相比,ARB和β-阻断剂在降低痴呆风险方面显示出潜在的好处.
- 除了降低血压之外,考虑AHM类效应对于优化老年高血压患者痴呆风险管理至关重要.
相关概念视频
01:16Antihypertensive Drugs: Action of Diuretics
630
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
630
01:30Dementia
107
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
107
01:22Alzheimer's Disease: Treatment
170
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
170
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
398
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
398
01:25Antihypertensive Drugs: Direct Renin Inhibitors
510
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
510
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
500
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
500