Shah Raj C, Wilson Robert S, Bienias Julia L, Arvanitakis Zoe, Evans Denis A, Bennett David A
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
Neuroepidemiology. 2006;26(1):30-6. doi: 10.1159/000089235. Epub 2005 Oct 25.
To examine the relation of systolic and diastolic blood pressure to incident Alzheimer's disease (AD) and rate of cognitive change.
Longitudinal cohort study with annual clinical evaluations. At baseline, blood pressure was measured, apolipoprotein E (APOE) genotyping was performed, and medications were reviewed.
824 older Catholic clergy members without baseline dementia were recruited from across the United States. During a mean of about 6 years of observation, 151 persons developed AD. In a proportional hazards model adjusted for age, sex and education, neither systolic (relative risk = 0.995; 95% CI: 0.986, 1.004, p = 0.249) nor diastolic (relative risk = 1.000; 95% CI: 0.985, 1.015, p = 0.975) blood pressure was related to AD incidence. In mixed effects models, neither systolic nor diastolic blood pressure was related to level or to annual rate of change on a global measure of cognition. These results did not change in subsequent models that accounted for the use of medications with antihypertensive properties or for the possession of an APOE epsilon4 allele.
In a cohort of older persons with a majority taking medications with antihypertensive properties, we did not find a relationship between blood pressure and risk of AD or cognitive decline.
研究收缩压和舒张压与阿尔茨海默病（AD）发病及认知变化率之间的关系。
进行年度临床评估的纵向队列研究。在基线时测量血压，进行载脂蛋白E（APOE）基因分型，并审查用药情况。
从美国各地招募了824名无基线痴呆的老年天主教神职人员。在平均约6年的观察期内，151人患上了AD。在调整了年龄、性别和教育程度的比例风险模型中，收缩压（相对风险=0.995；95%置信区间：0.986，1.004，p=0.249）和舒张压（相对风险=1.000；95%置信区间：0.985，1.015，p=0.975）均与AD发病率无关。在混合效应模型中，收缩压和舒张压均与整体认知测量的水平或年度变化率无关。在考虑使用具有降压特性的药物或携带APOE ε4等位基因的后续模型中，这些结果没有改变。
在一个大多数人服用具有降压特性药物的老年人群队列中，我们没有发现血压与AD风险或认知衰退之间的关系。
