Huang Wei-Shih, Tseng Chun-Hung, Lin Cheng-Li, Lin Chi-Yu, Sung Fung-Chang, Kao Chia-Hung
Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
Dement Geriatr Cogn Disord. 2014;37(5-6):357-65. doi: 10.1159/000357701. Epub 2014 Feb 8.
BACKGROUND/AIMS: We investigated the association of hypertensive encephalopathy (HE) with subsequent dementia.
Using universal insurance claims data, we identified a study cohort of 5,504 participants with HE newly diagnosed between 1997 and 2010 and a comparison cohort of 22,016 healthy participants. Incidence and risks of dementia were estimated for both cohorts until the end of 2010.
The dementia incidence was 1.45-fold [95% confidence interval (CI) = 1.27-1.66] higher in the study cohort than in the comparison cohort, with an adjusted hazard ratio (HR) of 1.38 (95% CI = 1.19-1.59) for the study cohort. The risk was higher for males than for females and elderly patients. With an incidence of 13.4 per 1,000 person-years, the HR of dementia increased to 2.09 (95% CI = 1.18-3.71) for the HE patients with the comorbidities of head injury and diabetes compared to those without HE and comorbidities. The risk of developing dementia declined with the follow-up time.
Hypertensive patients with HE displayed a significantly higher risk for dementia than those without HE. The risk increased further in those with the comorbidities of head injury and diabetes. Physicians should be aware of the link between HE and dementia when assessing patients with HE.
背景/目的：我们研究了高血压脑病（HE）与随后发生的痴呆之间的关联。
利用全民保险理赔数据，我们确定了一个研究队列，其中包括1997年至2010年间新诊断出的5504名HE患者，以及一个由22016名健康参与者组成的对照队列。对两个队列直至2010年底的痴呆发病率和风险进行了评估。
研究队列中的痴呆发病率比对照队列高1.45倍[95%置信区间（CI）=1.27 - 1.66]，研究队列的校正风险比（HR）为1.38（95%CI = 1.19 - 1.59）。男性、老年患者的风险高于女性。对于合并头部损伤和糖尿病的HE患者，痴呆发病率为每1000人年13.4例，与无HE及合并症的患者相比，其痴呆的HR增至2.09（95%CI = 1.18 - 3.71）。痴呆发生风险随随访时间下降。
患有HE的高血压患者发生痴呆的风险显著高于未患HE的患者。合并头部损伤和糖尿病的患者风险进一步增加。医生在评估HE患者时应注意HE与痴呆之间的联系。
