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老年高血压患者血压变异性与认知功能的关系,血压控制良好。

Relationship between blood pressure variability and cognitive function in geriatric hypertensive patients with well-controlled blood pressure.

机构信息

Department of Cardiology, Biruni University Faculty of Medicine, Istanbul, Turkey.

Department of Internal Medicine, Biruni University Faculty of Medicine, Istanbul, Turkey.

出版信息

Aging Clin Exp Res. 2020 Jan;32(1):93-98. doi: 10.1007/s40520-019-01141-6. Epub 2019 Feb 1.

Abstract

BACKGROUND

Hypertension is an important risk factor for cardiovascular diseases and cognitive function. Blood pressure (BP) variability has been associated with cognitive dysfunction, but data are sparse regarding the relationship between BP variability and cognitive function in geriatric patients with well-controlled BP.

AIM

The aim of this study was to demonstrate the relationship between blood pressure variability and cognitive functions in geriatric hypertensive patients with well-controlled BP.

METHOD

We analyzed 435 hypertensive patients (167 male, 74.9 ± 8.3; 268 female, 76.1 ± 8.6) treated at least with one antihypertensive drug. All patients underwent ambulatory BP monitoring and the standardized mini mental test (sMMT).

RESULTS

We divided the weighted standard deviation (SD) of systolic BP (SBP) as a measure of BP variability into quartiles. The top quartile group (≥ 18.5 mmHg) had a significantly lower total sMMT score (23.3 ± 3.2, p < 0.001). According to the results of multivariate logistic regression analysis for sMMT, the SD of 24-h SBP was related to sMMT (p = 0.007, 95% confidence interval - 0.301 [- 0.370 to - 0.049]).

DISCUSSION

Although there are some inconsistencies among the studies investigating the relationship between blood pressure variability and cognitive functions in elderly patients, we demonstrated the relationship between increased 24-h blood pressure variability and cognitive functions assessed with sMMT in geriatric population with well-controlled BP.

CONCLUSION

The increased blood pressure variability was associated with poorer cognitive functions in geriatric hypertensive patients with well-controlled blood pressure.

摘要

背景

高血压是心血管疾病和认知功能的重要危险因素。血压变异性与认知功能障碍有关,但关于血压控制良好的老年患者血压变异性与认知功能之间的关系的数据很少。

目的

本研究旨在证明血压控制良好的老年高血压患者血压变异性与认知功能之间的关系。

方法

我们分析了 435 名高血压患者(167 名男性,74.9±8.3;268 名女性,76.1±8.6),至少使用一种降压药治疗。所有患者均接受动态血压监测和标准化简易精神状态检查(sMMT)。

结果

我们将收缩压(SBP)变异性的加权标准差(SD)分为四分位数。血压变异性最高四分位组(≥18.5mmHg)的总 sMMT 评分明显较低(23.3±3.2,p<0.001)。根据 sMMT 的多变量逻辑回归分析结果,24 小时 SBP 的 SD 与 sMMT 相关(p=0.007,95%置信区间-0.301[-0.370 至-0.049])。

讨论

尽管一些研究在调查老年患者血压变异性与认知功能之间的关系时存在一些不一致之处,但我们证明了血压控制良好的老年人群中,24 小时血压变异性与 sMMT 评估的认知功能之间存在关系。

结论

血压变异性增加与血压控制良好的老年高血压患者认知功能较差有关。

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