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在成年人中,静脉压低于130毫米升的静脉压和认知功能:来自SPRINT-MIND试验的见解

Ruixue Yang¹, Zhou Fang², Daman Yang³

¹Hypertension Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Chinese Institutes for Medical Research, China (R.Y., Q.L., T.G., J.C.).

Circulation. Cardiovascular quality and outcomes

|October 10, 2025

概括

在达到静缩血压 (SBP) <130 mmHg的患者中,降低静缩血压 (DBP) 并没有显著增加痴呆症风险. 然而,升高的DBP与大脑血流受损有关,突出显示了大脑健康的复杂关系.

科学领域:

心脏病学心脏病学
神经学神经学
老年学是一门学科.

背景情况:

人们对强度缩血压 (SBP) 降低存在担忧,因为它可能与缩血压 (DBP) 和认知结果之间存在J形关系.
目前的指导方针建议更严格的SBP目标 (<130 mmHg),但缺乏明确的DBP目标,特别是在大脑健康方面.

研究的目的:

调查治疗的DBP与认知功能,大脑输液和大脑结构之间的关联,这些成年人达到SBP<130 mmHg.
为了确定较低的DBP是否与不良的认知结果或在SBP严格控制下大脑指标的变化有关.

主要方法:

对SPRINT-MIND试验的二次分析,包括高血压参与者,达到SBP<130 mmHg.
基于DBP类别和连续DBP的认知结果 (痴呆症,轻度认知障碍) 和大脑指标 (大脑血流,白质病变,大脑体积) 的评估.
使用考克斯回归和线性混合模型进行统计分析.

主要成果:

在共变量调整后,在治疗期间低的DBP与可能的痴呆症或轻度认知障碍的风险增加没有显著关联.
经过治疗的DBP与白质病变或总脑体积的变化没有关联.
在实现的DBP和大脑血流变化之间观察到显著的反向关系,表明高DBP的输液受损.

结论:

在达到SBP<130 mmHg的患者中,接受治疗的DBP与痴呆症,轻度认知障碍或大脑结构变化无关.
在治疗期间增加的DBP与大脑输液受损的风险增加有关.
这些发现表明DBP,SBP控制和大脑输液之间存在复杂的相互作用,因此需要进一步研究最佳的DBP对脑健康的目标.

关键词:

血压血压血压血压认知认知认知痴呆症痴呆症是一种痴呆症.这种高血压,高血压.有关风险因素的风险因素.

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