Kovács Katalin Réka, Bajkó Zoltán, Szekeres Csilla Cecília, Csapó Krisztina, Oláh László, Magyar Mária Tünde, Molnár Sándor, Czuriga Dániel, Kardos László, Burainé Andrea Bojtor, Bereczki Dániel, Soltész Pál, Csiba László
Department of Neurology, Clinical Center, University of Debrecen, Debrecen, Hungary.
Department of Neurology, Mureş County Clinical Emergency Hospital, Târgu-Mureş, Romania.
J Am Soc Hypertens. 2014 Aug;8(8):550-60. doi: 10.1016/j.jash.2014.04.007. Epub 2014 Apr 26.
Hypertension and dyslipidemia belong to the most prevalent modifiable risk factors for cerebrovascular and cardiovascular diseases. Hereby, we aimed to examine the combined effects of newly diagnosed hypertension and hyperlipidemia on the characteristics of the arterial wall and on cognitive function. We examined 72 hypertensive and 85 apparently healthy individuals. Based on serum lipid levels, four subgroups were created ranging from normotensive-normolipidemic to hypertensive-hyperlipidemic subjects. Carotid intima-media thickness (IMT), arterial stiffness, and cognitive function were assessed. IMT of controls was the lowest, whereas that of patients with both risk factors the highest. Stiffness parameters increased when both risk factors were present, whereas subjects with only one risk factor exhibited intermediate values. Hypertensive patients performed worse when memory, attention, reaction time, and trait anxiety were assessed. Significant worsening of IMT, arterial stiffness, and sum of neuropsychological scores was observed along with increasing mean arterial pressure. Generally, hyperlipidemia combining with hypertension resulted in further worsening of all examined parameters. Subclinical changes of the vascular wall and cognitive performance are already present in recently diagnosed hypertensive patients. Combination of hyperlipidemia and hypertension results in more severe impairments, therefore, early and intensive treatment may be crucial to prevent further deterioration.
高血压和血脂异常是脑血管病和心血管病最常见的可改变危险因素。在此,我们旨在研究新诊断的高血压和血脂异常对动脉壁特征和认知功能的联合影响。我们检查了72名高血压患者和85名明显健康的个体。根据血脂水平,创建了四个亚组,从血压正常-血脂正常到高血压-高血脂受试者。评估了颈动脉内膜中层厚度(IMT)、动脉僵硬度和认知功能。对照组的IMT最低,而同时具有两种危险因素的患者的IMT最高。当两种危险因素都存在时,僵硬度参数增加,而只有一种危险因素的受试者表现出中间值。在评估记忆、注意力、反应时间和特质焦虑时,高血压患者表现较差。随着平均动脉压升高,观察到IMT、动脉僵硬度和神经心理评分总和显著恶化。一般来说,血脂异常合并高血压会导致所有检查参数进一步恶化。新诊断的高血压患者已经出现血管壁和认知表现的亚临床变化。血脂异常和高血压的合并会导致更严重的损害,因此,早期和强化治疗对于预防进一步恶化可能至关重要。