Li Min, Liu Lei, Song Shaowu, Shi Anshi, Ma Yunlong, Zhang Songlin, Wang Zengwu, Zhu Danjun, Tian Gang
Department of Cardiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi, China Jinduicheng Molybdenum Company Employees Hospital Hancheng Mining Bureau General Hospital, Weinan, Shaanxi Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Xicheng District, Beijing, P. R.
Medicine (Baltimore). 2018 Aug;97(34):e11975. doi: 10.1097/MD.0000000000011975.
The incidence of hypertension in China is high, which seriously affects people's health, including occupational population in mining areas. Cognitive dysfunction has a serious impact on the work and life of patients. Lifestyle intervention can improve diabetes and cardiovascular diseases. However, there are few studies on the effects of lifestyle interventions on cognitive function in hypertensive patients. So the aim of this study was to analyze the effect of long-term lifestyle intervention on mild cognitive impairment in hypertensive occupational population in China.
In September 2013, a cluster sampling was conducted for the workers in the Shaanxi Jinduicheng (intervention group) and Hancheng (control group) mining areas. In both groups, according to the blood pressure (BP) level, they were divided into hypertension stage 1 to 3 subgroups; according to their age, they were divided into between 45 and 59 and under 45 years subgroups; and according to whether or not taking medicine, they were divided into Lifestyle intervention, Lifestyle intervention plus medication, Medication, and No lifestyle intervention nor medication subgroups. The intervention group received regular lifestyle intervention for 2 years, which included diet, smoke, drink, and exercise intervention. Mild cognitive impairment was measured by the Montreal Cognitive Assessment (MoCA). The arterial stiffness was measured by Omron Automatic Atherosclerosis Tester. We conducted BP measurement and MoCA questionnaire at baseline, 6, 12, and 24 months.
We analyzed a total of 510 mine workers, whose average age was 45.6 ± 13.4 years old. With the increase of BP level, the MoCA scores decreased significantly both in control and lifestyle intervention groups (P < .05). There was no obvious difference between the hypertensive patients whose age was between 45 and 59 to those under 45 in MoCA scores (P > .05). After 2 years, the BP, total cholesterol, glucose, and brachial-ankle pulse wave velocity of the Lifestyle intervention subgroup and Lifestyle intervention plus medication subgroup decreased (P < .05), and the MoCA scores and ankle-brachial index increased (P < .05), and the latter improved more significantly. Compared with the No lifestyle intervention nor medication subgroup, the BP and MoCA scores had no obvious changes at 6 months (P > .05), but the BP decreased and the MoCA scores increased significantly in the Lifestyle intervention and Lifestyle intervention plus medication subgroups after 1 and 2 years of lifestyle intervention (P < .05).
Long-term lifestyle intervention can be used as adjunctive therapy to improve the BP and cognitive function of hypertensive occupational population in China.
中国高血压发病率较高，严重影响人们的健康，包括矿区职业人群。认知功能障碍对患者的工作和生活有严重影响。生活方式干预可改善糖尿病和心血管疾病。然而，关于生活方式干预对高血压患者认知功能影响的研究较少。因此，本研究旨在分析长期生活方式干预对中国高血压职业人群轻度认知障碍的影响。
2013年9月，对陕西金堆城（干预组）和韩城（对照组）矿区的工人进行整群抽样。两组均根据血压（BP）水平分为高血压1至3期亚组；根据年龄分为45至59岁和45岁以下亚组；根据是否服药分为生活方式干预、生活方式干预加药物治疗、药物治疗以及无生活方式干预和未服药亚组。干预组接受为期2年的定期生活方式干预，包括饮食、吸烟、饮酒和运动干预。采用蒙特利尔认知评估量表（MoCA）测量轻度认知障碍。使用欧姆龙自动动脉硬化检测仪测量动脉僵硬度。在基线、6个月、12个月和24个月时进行血压测量和MoCA问卷调查。
共分析510名矿工，平均年龄为45.6±13.4岁。随着BP水平的升高，对照组和生活方式干预组的MoCA评分均显著降低（P<0.05）。年龄在45至59岁的高血压患者与45岁以下患者的MoCA评分无明显差异（P>0.05）。2年后，生活方式干预亚组和生活方式干预加药物治疗亚组的血压、总胆固醇、血糖和臂踝脉搏波速度降低（P<0.05），MoCA评分和踝臂指数升高（P<0.05），后者改善更显著。与无生活方式干预和未服药亚组相比，生活方式干预6个月时血压和MoCA评分无明显变化（P>0.05），但生活方式干预1年和2年后，生活方式干预亚组和生活方式干预加药物治疗亚组的血压降低，MoCA评分显著升高（P<0.05）。
长期生活方式干预可作为辅助治疗方法，改善中国高血压职业人群的血压和认知功能。
