关于24小时门诊血压和认知功能的低压情节:来自SPRINT研究的见解
Wenxin Zhang1, Susan Redline2,3, Anand Viswanathan4
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (W.Z., D.H., M.A.M., Y.M.).
Hypertension (Dallas, Tex. : 1979)
|January 22, 2025
概括
通过24小时的门诊血压监测检测到的经常性低血压发作与认知能力下降有关,特别是在处理速度方面. 这一发现表明,管理血压和预防痴呆症的潜在新标志物.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 老年学是一门学科.
背景情况:
- 24小时的门诊血压 (BP) 监测可以检测每天的低血压压力.
- 低血压发作和认知障碍之间的联系尚未得到充分理解.
- 之前的研究还没有充分探讨出院血压监测对认知功能的影响.
研究的目的:
- 研究高血压患者的低血压发作和认知功能之间的关联.
- 为了确定低血压的持续时间和频率是否会影响认知表现.
- 探索强化高血压治疗对低血压事件和认知结果的作用.
主要方法:
- 利用了来自缩血压干预试验的数据,包括842名接受过治疗的高血压参与者.
- 评估了24小时的门诊血压监测和认知评估 (蒙特利尔认知评估,数字符号编码).
- 采用线性混合模型来分析低血压事件/持续时间和认知功能之间的关联,调整BP变化.
主要成果:
- 经常出现的低血压发作 (静脉血压下降≥20 mm Hg至<100 mm Hg) 与较低的数字符号编码得分和更快的认知衰退有关.
- 较长的低血压持续时间显示了剂量反应关系与较差的认知评分.
- 强化高血压治疗增加了低血压发作,并影响了它们与认知能力下降的关联.
结论:
- 24小时低血压发作与认知功能受损有关,特别是处理速度.
- 门诊血压监测可以作为优化血压控制的新标志物.
- 这些发现表明在痴呆症预防策略中可能发挥作用.
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