老年人血压降低与灰质完整性丧失
Lower Blood Pressure and Gray Matter Integrity Loss in Older Persons.
作者信息
Foster-Dingley Jessica C, Moonen Justine E F, van den Berg-Huijsmans Anne A, de Craen Anton J M, de Ruijter Wouter, van der Grond Jeroen, van der Mast Roos C
机构信息
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
出版信息
J Clin Hypertens (Greenwich). 2015 Aug;17(8):630-7. doi: 10.1111/jch.12550. Epub 2015 Apr 13.
In contrast to middle age, it is unclear whether blood pressure (BP) in older persons is associated with cerebral small vessel disease (cSVD). The authors evaluated the association of BP with signs of cSVD as well as gray and white matter integrity in older persons. In 220 participants aged 75 years and older from the Discontinuation of Antihypertensive Treatment in the Elderly (DANTE) study, cSVD was assessed with conventional magnetic resonance imaging, and microstructural integrity with diffusion tensor and magnetization transfer (MT) imaging. BP measures were not associated with cSVD. However, lower systolic and diastolic BP and mean arterial pressure were associated with decreased gray matter MT ratio peak height and MT ratio in cortical gray matter. Mean arterial pressure was also associated with increased gray matter diffusivity. A lower level of BP was especially associated with worse gray matter integrity. Results suggest that not only upper but preferably lower thresholds of BP values should be observed in older persons.
与中年情况不同的是，老年人的血压（BP）是否与脑小血管疾病（cSVD）相关尚不清楚。作者评估了老年人血压与cSVD体征以及灰白质完整性之间的关联。在老年高血压治疗终止（DANTE）研究中的220名75岁及以上参与者中，使用传统磁共振成像评估cSVD，并使用扩散张量和磁化传递（MT）成像评估微观结构完整性。血压测量值与cSVD无关。然而，较低的收缩压、舒张压和平均动脉压与皮质灰质中灰质MT比率峰值高度降低以及MT比率降低相关。平均动脉压也与灰质扩散率增加相关。较低水平的血压尤其与较差的灰质完整性相关。结果表明，老年人不仅应关注血压值的上限，更应关注下限。
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