Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH Baltimore, Baltimore, Maryland.
Department of Psychology and Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, Maine, USA.
J Hypertens. 2018 Feb;36(2):268-276. doi: 10.1097/HJH.0000000000001510.
There is evidence to suggest that intraindividual variability in blood pressure (BP IIV) may be superior to mean BP for predicting cognitive function, taken from both within a single visit and between-visits. BP IIV increases with age in studies of persons middle-aged and older. The aim was therefore to investigate age by BP IIV (SBP and DBP) interactions with regard to cognitive functioning while considering medication class and polypharmacy, which may also affect BP IIV with advancing age.
Cross-sectional analyses were performed on 980 community-dwelling individuals from the Maine-Syracuse Longitudinal Study. Automated BP measures were taken 15 times (five times each in sitting, reclining, and standing positions). Cognitive function was assessed using a thorough neuropsychological test battery following the BP assessment. A significant age by BP IIV interaction was observed. For individuals aged over age 60 years, IIV in SBP and DBP was inversely associated with Global Composite, Scanning and Tracking, and the Similarities test. IIV in SBP was additionally associated with Verbal Memory and the Mini-Mental State Examination. DBP IIV was additionally related to the Visual-Spatial Memory and Organization composite. There were no significant associations between BP IIV and cognitive function in those aged less than 60 years.
BP IIV is an important predictor of cognition with advancing age.
有证据表明,血压个体内变异性(BP IIV)可能优于平均血压,可用于预测认知功能,无论是在单次就诊内还是就诊间均如此。在对中年及以上人群的研究中,BP IIV 随年龄增长而增加。因此,本研究旨在考虑药物种类和多药治疗等可能随年龄增长而影响 BP IIV 的因素,探讨血压个体内变异性(SBP 和 DBP)与认知功能之间的年龄交互作用。
对缅因州-锡拉丘兹纵向研究中的 980 名社区居住者进行了横断面分析。采用自动血压计在坐、卧和站立位各测量 5 次,共 15 次。在进行血压评估后,使用全面的神经心理学测试工具包评估认知功能。观察到年龄与 BP IIV 之间存在显著的交互作用。对于年龄在 60 岁以上的个体,SBP 和 DBP 的 IIV 与总体综合评分、扫描和跟踪以及相似性测试呈负相关。SBP 的 IIV 与言语记忆和简易精神状态检查呈额外相关。DBP 的 IIV 与视觉空间记忆和组织综合评分呈额外相关。在年龄小于 60 岁的个体中,BP IIV 与认知功能之间无显著关联。
随着年龄的增长,BP IIV 是认知功能的重要预测指标。