Department of Neurology, Academic Medical Center, Amsterdam.
Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen.
J Hypertens. 2018 Sep;36(9):1780-1787. doi: 10.1097/HJH.0000000000001829.
: Our objective was to study the preventive effect of lowering blood pressure (BP) by medication and/or lifestyle changes on incident all-cause dementia, Alzheimer's disease and vascular dementia. In this systematic review, we included randomized controlled trials with a BP-lowering intervention. Of the nine included trials, seven assessed the effect of antihypertensive medication and two of a lifestyle or combined intervention. In the intervention arm, 1041 out of 29 029 (3.6%) participants were diagnosed with dementia compared with 1090 out of 28 653 (3.8%) controls during a median follow-up of 3.9 years [range 2-10], resulting in a pooled risk ratio of 0.93 (95% confidence interval 0.84-1.02; I 16%). Three trials specified dementia subtypes, with no significant effect on Alzheimer's disease or vascular dementia. To conclude, lowering BP by medication and/or lifestyle changes did not lead to a significantly reduced risk of dementia. This appeared independent of dementia subtype.
我们的目的是研究通过药物治疗和/或生活方式改变降低血压对新发全因痴呆、阿尔茨海默病和血管性痴呆的预防作用。在本系统评价中，我们纳入了降压干预的随机对照试验。在纳入的九项试验中，有七项评估了抗高血压药物的效果，有两项评估了生活方式或联合干预的效果。在干预组中，29029 名参与者中有 1041 人（3.6%）被诊断为痴呆，而 28653 名对照组中有 1090 人（3.8%），中位随访时间为 3.9 年[范围 2-10]，汇总风险比为 0.93（95%置信区间 0.84-1.02；I 16%）。有三项试验明确了痴呆亚型，对阿尔茨海默病或血管性痴呆没有显著影响。总之，通过药物治疗和/或生活方式改变降低血压并不能显著降低痴呆的风险。这似乎与痴呆亚型无关。
