Wu Lei, He Yao, Jiang Bin, Liu Miao, Wang Jianhua, Yang Shanshan, Wang Yiyan
Department of Epidemiology, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China.
Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China.
Hypertens Res. 2016 May;39(5):367-75. doi: 10.1038/hr.2015.146. Epub 2016 Jan 7.
It remains unclear whether lowering the blood pressure effectively prevents cognitive impairment. The aim of the current study was to explore the association between the prevalence, treatment and control of hypertension and the risk of mild cognitive impairment (MCI) among elderly Chinese people. This is a cross-sectional study conducted in Beijing, China. A two-stage stratified clustering sampling method was used, and 2065 participants, aged ⩾60 years, were included in the analysis. The Mini-Mental State Examination was used to assess participants' cognitive function. The prevalence of MCI was higher in hypertensive (16.5%) than in normotensive individuals (13.1%; P=0.043). Furthermore, in those hypertensive patients, the prevalence of MCI was lower in those treated (14.9%) than in those not treated (19.9%; P=0.019) and lower in those controlled (13.4%) than in those uncontrolled (17.9%; P=0.042). The adjusted odds ratio (OR; 95% confidence interval (CI)) of having MCI was 1.59 (1.07-2.35) in those with hypertension compared with those normotensive individuals. The assessment of the hypertensive patients revealed the adjusted OR (95% CI) of having MCI in those with treated hypertension was 0.60 (0.42-0.86) compared with those untreated hypertension, and in those with controlled hypertension was 0.64 (0.43-0.93) compared with those non-controlled hypertension (regardless of treatment). However, among the treated hypertensive patients, there was no difference in the prevalence of MCI between the patients who reached and those who did not reach their treatment goal. We suggest that improved diagnoses and optimal therapeutics are needed to achieve the aim of cognitive decline prevention.
降低血压是否能有效预防认知障碍仍不清楚。本研究的目的是探讨中国老年人高血压的患病率、治疗及控制情况与轻度认知障碍(MCI)风险之间的关联。这是一项在中国北京进行的横断面研究。采用两阶段分层整群抽样方法,纳入2065名年龄≥60岁的参与者进行分析。采用简易精神状态检查表评估参与者的认知功能。高血压患者中MCI的患病率(16.5%)高于血压正常者(13.1%;P=0.043)。此外,在这些高血压患者中,接受治疗者的MCI患病率(14.9%)低于未接受治疗者(19.9%;P=0.019),血压得到控制者的MCI患病率(13.4%)低于未得到控制者(17.9%;P=0.042)。与血压正常者相比,高血压患者发生MCI的校正比值比(OR;95%置信区间(CI))为1.59(1.07 - 2.35)。对高血压患者的评估显示,与未治疗的高血压患者相比,接受治疗的高血压患者发生MCI的校正OR(95%CI)为0.60(0.42 - 0.86),与血压未得到控制的高血压患者(无论是否接受治疗)相比,血压得到控制的高血压患者发生MCI的校正OR为0.64(0.43 - 0.93)。然而,在接受治疗的高血压患者中,达到和未达到治疗目标的患者之间MCI患病率没有差异。我们建议需要改进诊断和优化治疗方法以实现预防认知衰退的目标。