Nash David T, Fillit Howard
Upstate Medical University, Syracuse Preventive Cardiology, Syracuse, New York, USA.
Am J Cardiol. 2006 Apr 15;97(8):1262-5. doi: 10.1016/j.amjcard.2005.12.031. Epub 2006 Mar 3.
The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.
心血管疾病风险因素在认知功能障碍的发生和发展中所起的作用，已成为大量出版物的主题，但在许多医生和受过教育的外行中尚未得到广泛认可。显然，积极治疗其中某些心血管疾病风险因素会降低认知功能障碍的风险。接受治疗的高血压患者比未接受类似治疗的患者经历的心血管疾病事件更少，认知功能障碍也更少。进行锻炼的患者可能出现的认知功能障碍较少，而肥胖可能会增加认知功能障碍的风险。血脂异常和基因标记与心血管疾病和认知功能障碍风险增加有关。尸检研究表明，大脑中胆固醇水平升高与淀粉样蛋白沉积之间存在关联。研究表明， Willis 环中的动脉粥样硬化阻塞性病变与痴呆症之间存在关联。糖尿病与心血管疾病和认知功能障碍风险增加有关。一些非药物因素在降低认知功能障碍风险方面发挥着作用。抗氧化剂、脂肪酸和微量营养素可能发挥作用，富含水果和蔬菜的饮食以及其他饮食方法可能会改善被认为有认知功能障碍风险的患者的前景。
