Skoog Ingmar, Gustafson Deborah
Institute of Neuroscience and Physiology, Section of Psychiatry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Neurol Res. 2006 Sep;28(6):605-11. doi: 10.1179/016164106X130506.
Several studies report that blood pressure is increased in victims of Alzheimer's disease (AD) decades before the onset of the disease. Years before onset of Alzheimer's disease, blood pressure start to decrease and continues to decrease during the disease process. High blood pressure has also been related to pathological manifestations of Alzheimer's disease (senile plaques, neurofibrillary tangles, hippocampal atrophy). The exact mechanism behind these associations is not clear. Hypertension is also a risk factor for stroke, ischemic white matter lesions, silent infarcts, general atherosclerosis, myocardial infarction and cardiovascular diseases, and often clusters with other vascular risk factors, including diabetes mellitus, obesity and hypercholesterolemia. Also these risk factors have been related to Alzheimer's disease. Hypertension may thus cause cerebrovascular disease that may increase the possibility for individuals with AD encephalopathy to express a dementia syndrome. Hypertension may also lead to vessel wall changes in the brain, leading to hypoperfusion, ischemia and hypoxia which may initiate the pathological process of AD. Finally, subclinical AD may lead to increased blood pressure, and similar biological mechanisms may be involved in the pathogenesis of both disorders. Hypertension is a common disorder and often untreated. Several observational studies have reported that use of antihypertensives decreases risk of AD. Even though hypertension only results in a moderately increased risk of AD, or overall dementia, better treatment of hypertension may have an immense effect on the total number of demented individuals.
多项研究报告称，在阿尔茨海默病（AD）患者发病前数十年，其血压就已升高。在阿尔茨海默病发病前数年，血压开始下降，并在疾病过程中持续下降。高血压还与阿尔茨海默病的病理表现（老年斑、神经纤维缠结、海马萎缩）有关。这些关联背后的确切机制尚不清楚。高血压也是中风、缺血性白质病变、无症状梗死、全身动脉粥样硬化、心肌梗死和心血管疾病的危险因素，并且常与其他血管危险因素聚集在一起，包括糖尿病、肥胖症和高胆固醇血症。而且这些危险因素也与阿尔茨海默病有关。因此，高血压可能导致脑血管疾病，这可能会增加患有AD脑病的个体出现痴呆综合征的可能性。高血压还可能导致大脑血管壁变化，导致灌注不足、缺血和缺氧，从而可能引发AD的病理过程。最后，亚临床AD可能导致血压升高，两种疾病的发病机制可能涉及相似的生物学机制。高血压是一种常见疾病，且常常未得到治疗。多项观察性研究报告称，使用抗高血压药物可降低患AD的风险。尽管高血压仅导致患AD或总体痴呆的风险适度增加，但更好地治疗高血压可能会对痴呆患者的总数产生巨大影响。
