The Florey Institute of Neuroscience and Mental Health, Austin Health, Heidelberg, VIC, Australia.
Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, VIC, Australia.
J Hum Hypertens. 2018 Mar;32(3):171-179. doi: 10.1038/s41371-017-0023-0. Epub 2018 Jan 12.
Cognitive impairment is common in patients with hypertension. Left ventricular hypertrophy (LVH) is recognised as a marker of hypertension-related organ damage and is a strong predictor of coronary artery disease, heart failure and stroke. There is evidence that LVH is independently associated with cognitive impairment, even after adjustment for the presence of hypertension. We conducted a systematic review that examined cognitive impairment in adults with LVH. Independent searches were performed in Ovid MEDLINE, Ovid psycInfo and PubMed with the terms left ventricular hypertrophy and cognition. Seventy-three studies were identified when both searches were combined. After limiting the search to studies that were: (1) reported in English; (2) conducted in humans; (3) in adults aged 50 years and older; and (4) investigated the relationship between LVH and cognitive performance, nine papers were included in this systematic review. The majority of studies found an association between LVH and cognitive performance. Inspection of results indicated that individuals with LVH exhibited a lower performance in cognitive tests, when compared to individuals without LVH. Memory and executive functions were the cognitive domains that showed a specific vulnerability to the presence of LVH. A possible mechanism for the relationship between LVH and cognition is the presence of cerebral white matter damage. White matter lesions occur frequently in patients with LVH and may contribute to cognitive dysfunction. Together, the results of this review suggest that memory impairment and executive dysfunction are the cognitive domains that showed a particular association with the presence of LVH.
认知障碍在高血压患者中很常见。左心室肥厚（LVH）被认为是与高血压相关的器官损伤的标志物，也是冠心病、心力衰竭和中风的强有力预测指标。有证据表明，即使在调整了高血压的存在后，LVH 仍与认知障碍独立相关。我们进行了一项系统评价，研究了 LVH 成年人的认知障碍。在 Ovid MEDLINE、Ovid psycInfo 和 PubMed 中使用左心室肥厚和认知这两个术语进行了独立搜索。当两次搜索结合时，共确定了 73 项研究。在将搜索范围限制为以下研究后：(1) 用英文报告；(2) 在人类中进行；(3) 在年龄为 50 岁及以上的成年人中进行；(4) 调查 LVH 与认知表现之间的关系，有 9 篇论文被纳入本系统评价。大多数研究发现 LVH 与认知表现之间存在关联。检查结果表明，与没有 LVH 的个体相比，LVH 个体在认知测试中的表现较低。记忆和执行功能是对 LVH 存在表现出特殊易感性的认知领域。LVH 和认知之间关系的一种可能机制是脑白质损伤的存在。LVH 患者经常出现白质病变，可能导致认知功能障碍。总之，本综述的结果表明，记忆障碍和执行功能障碍是与 LVH 存在特别相关的认知领域。
