Sakakura Kenichi, Ishikawa Joji, Okuno Masataka, Shimada Kazuyuki, Kario Kazuomi
Department of Medicine, Omiya Medical Center, Jichi Medical University School of Medicine, Saitma, Japan.
Am J Hypertens. 2007 Jul;20(7):720-7. doi: 10.1016/j.amjhyper.2007.02.001.
It is reported that blood pressure (BP) variability increases with aging, and cognitive dysfunction may be related to BP variability; however, there are no data showing that exaggerated BP variability is associated with cognitive dysfunction or quality of life (QOL) in the older elderly. We investigated the relationships and the differences between ambulatory BP variability and cognitive function or QOL in younger elderly and very elderly.
We recruited both 101 very elderly (aged > or =80 years) and 101 younger elderly (aged 61 to 79 years). Twenty-four-hour ambulatory blood pressure monitoring, mini-mental state examinations (MMSE), and Medical Outcome Study Short-Form 36 Items Health Survey (SF-36) were performed for all subjects.
The mean standard deviation (SD) of daytime systolic BP in young elderly was 17.2 +/- 4.6 mm Hg (mean SD +/- SD of mean SD), and that in very elderly was 21.2 +/- 4.3 mm Hg. The MMSE score significantly decreased with the tertile of SD of daytime systolic BP in very elderly (P = .004) and young elderly (P = .03). In very elderly, there was no significant association between the SD of daytime systolic BP and each of eight SF-36 categories. On the other hand, in younger elderly, two of eight SF-36 categories decreased with the tertile of SD of daytime systolic BP (P = .001 for Vitality and P = .003 for Role emotion).
Very elderly had larger BP variability than younger elderly. Exaggerated ambulatory BP variability was related to cognitive dysfunction in the elderly, especially in the very elderly, and was related to lower QOL in the younger elderly.
据报道，血压变异性随年龄增长而增加，且认知功能障碍可能与血压变异性有关；然而，尚无数据表明血压变异性过大与高龄老年人的认知功能障碍或生活质量（QOL）相关。我们研究了老年前期和高龄老年人动态血压变异性与认知功能或生活质量之间的关系及差异。
我们招募了101名高龄老年人（年龄≥80岁）和101名老年前期老年人（年龄61至79岁）。对所有受试者进行了24小时动态血压监测、简易精神状态检查（MMSE）和医学结局研究简明健康调查36项问卷（SF-36）。
老年前期老年人日间收缩压的平均标准差（SD）为17.2±4.6 mmHg（平均SD±平均SD的SD），高龄老年人为21.2±4.3 mmHg。高龄老年人（P = .004）和老年前期老年人（P = .03）的MMSE评分均随日间收缩压SD三分位数的升高而显著降低。在高龄老年人中，日间收缩压SD与SF-36的八个类别中的任何一个均无显著关联。另一方面，在老年前期老年人中，SF-36的八个类别中有两个随日间收缩压SD三分位数的升高而降低（活力维度P = .001，角色情感维度P = .003）。
高龄老年人的血压变异性比老年前期老年人更大。动态血压变异性过大与老年人尤其是高龄老年人的认知功能障碍有关，且与老年前期老年人较低的生活质量有关。
