Guo Z, Viitanen M, Winblad B, Fratiglioni L
Department of Clinical Neuroscience and Family Medicine, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
J Am Geriatr Soc. 1999 Jun;47(6):723-6. doi: 10.1111/j.1532-5415.1999.tb01597.x.
To examine whether initially low blood pressure is related to the incidence of dementia.
A population-based prospective study.
The Kungsholmen district of Stockholm, Sweden
Three hundred four nondemented subjects aged 75 to 96 years at baseline.
After an average of 3 years, 81 dementia cases were identified (67 with Alzheimer's disease cases). Compared with individuals with baseline systolic pressure of 141 to 179 mm Hg, those with systolic pressure < or = 140 mm Hg had a significantly higher risk of dementia (relative risk (RR) = 1.9, 95% confidence interval (CI), 1.2-3.2) and Alzheimer's disease (RR = 2.2, 95% CI, 1.2-3.8). However, the RR in relation to systolic pressure < or = 140 mm Hg was 1.3 (0.8-2.2) for all dementia and 1.5 (0.8-2.6) for Alzheimer's disease, when the baseline Mini-Mental State Examination (MMSE) score was included in the model as a dichotomous variable (< 24 vs > or = 24). Baseline MMSE < 24 significantly predicted the occurrence of dementia (RR = 6.9; 95% CI, 4.3-11.1). Systolic pressure < or = 140 mm Hg was significantly related to MMSE score < 24 at baseline.
These data suggest that low blood pressure may be an early correlate of a dementing process although a causative effect cannot be definitely ruled out.
研究初始低血压是否与痴呆发病率相关。
基于人群的前瞻性研究。
瑞典斯德哥尔摩的 Kungsholmen 区
304 名基线时年龄在 75 至 96 岁之间的非痴呆受试者。
平均 3 年后，确诊 81 例痴呆病例（67 例阿尔茨海默病病例）。与基线收缩压为 141 至 179 mmHg 的个体相比，收缩压≤140 mmHg 的个体患痴呆症的风险显著更高（相对风险（RR）=1.9，95%置信区间（CI），1.2 - 3.2）以及患阿尔茨海默病的风险更高（RR = 2.2，95%CI，1.2 - 3.8）。然而，当将基线简易精神状态检查表（MMSE）评分作为二分变量（<24 与≥24）纳入模型时，收缩压≤140 mmHg 对应的所有痴呆症的 RR 为 1.3（0.8 - 2.2），阿尔茨海默病的 RR 为 1.5（0.8 - 2.6）。基线 MMSE<24 显著预测了痴呆症的发生（RR = 6.9；95%CI，4.3 - 11.1）。收缩压≤140 mmHg 与基线时 MMSE 评分<24 显著相关。
这些数据表明低血压可能是痴呆过程的早期相关因素，尽管不能完全排除因果关系。
