Hestad Knut A, Engedal Knut
Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayInnlandet Hospital-Sanderud, Ottestad, Norway.
Drugs Aging. 2006;23(9):723-31. doi: 10.2165/00002512-200623090-00002.
High and low blood pressure and apolipoprotein (Apo)-E epsilon4 alleles have been shown to be associated with dementia of the Alzheimer's type. The aim of this study was to examine the relationship between Apo-E epsilon4 allele status and the effect of antihypertensive treatment on cognitive performance in persons > or =80 years of age.
A sample of 258 individuals 80-102 years of age was studied. Associations between the Mini-Mental State Examination (MMSE) score and treatment with antihypertensive medication, blood pressure, Apo-E polymorphism, sex, age and education were assessed. Patients treated with antihypertensive drugs typically used two to ten different medications.
Individuals with no Apo-E epsilon4 alleles who were not treated with antihypertensive medications had a significantly higher diastolic blood pressure than other participants in the study but no cognitive deficits. Participants who had at least one Apo-E epsilon4 allele who were not treated with antihypertensive medications scored significantly lower on the MMSE compared with other participants in the study.
Individuals with an Apo-E epsilon4 allele who were not treated with antihypertensive medication showed the poorest cognitive performance. This could suggest that individuals with the Apo-E epsilon4 allele may benefit cognitively from treatment with antihypertensive drugs.
高血压和低血压以及载脂蛋白（Apo）-Eε4等位基因已被证明与阿尔茨海默病型痴呆有关。本研究的目的是探讨Apo-Eε4等位基因状态与降压治疗对80岁及以上人群认知功能的影响之间的关系。
对258名年龄在80 - 102岁的个体进行了研究。评估简易精神状态检查表（MMSE）评分与降压药物治疗、血压、Apo-E多态性、性别、年龄和教育程度之间的关联。接受降压药物治疗的患者通常使用两到十种不同的药物。
未接受降压药物治疗且无Apo-Eε4等位基因的个体舒张压显著高于研究中的其他参与者，但无认知缺陷。未接受降压药物治疗且至少有一个Apo-Eε4等位基因的参与者在MMSE上的得分显著低于研究中的其他参与者。
未接受降压药物治疗的Apo-Eε4等位基因个体认知表现最差。这可能表明，Apo-Eε4等位基因个体可能从降压药物治疗中获得认知益处。
