Heizhati Mulalibieke, Wang Lin, Li Nanfang, Li Mei, Pan Fengyu, Yang Zhikang, Wang Zhongrong, Abudereyimu Reyila
Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People's Republic of China.
National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China.
Medicine (Baltimore). 2020 May;99(19):e19891. doi: 10.1097/MD.0000000000019891.
Uncertainty remains about the association of hypertension with mild cognitive impairment (MCI) in less-developed areas.This is a cross-sectional survey conducted in Xinjiang, a less-developed region in China between April and October 2019. We used multi-stage stratified sampling method to obtain study population aged ≥45 years, and we analyzed complete data for 3282 subjects. The Mini-Mental State Examination (MMSE) was used to assess cognitive function. MCI is defined as an MMSE score < 17 for illiterate subjects, <20 for subjects with 1 to 6 years of education, and <24 for subjects with ≥7 years of education.The prevalence of MCI was significantly higher in hypertensive subjects than in non-hypertensive subjects (22.1% vs 16.1%, P < .001) and higher in hypertensives with uncontrolled blood pressure (BP) than in those with controlled BP (27.5% vs 20.7%, P = .01). Hypertensive subjects had significantly lower each item score and total score of MMSE, compared to non-hypertensive subjects. Significant negative correlations were observed between systolic and diastolic BP with MMSE scores (P for all <.001). Multivariate logistic regression analysis showed that hypertension was the significant risk factor for the presence of MCI (OR = 1.62, 95%CI: 1.34, 2.35, P < .001), independent of such factors as gender, age, education attainment, and dyslipidemia.The prevalence of MCI is higher in hypertensive population, and hypertension is an independent risk factor for MCI in less-developed region, suggesting that hypertensives should be screened for MCI to provide improved diagnoses and optimal therapeutics for cognitive decline prevention, specially in settings with approximate conditions.
在欠发达地区,高血压与轻度认知障碍(MCI)之间的关联仍不明确。这是一项于2019年4月至10月在中国欠发达地区新疆进行的横断面调查。我们采用多阶段分层抽样方法获取年龄≥45岁的研究人群,并对3282名受试者的完整数据进行了分析。采用简易精神状态检查表(MMSE)评估认知功能。MCI的定义为:文盲受试者MMSE评分<17分,接受1至6年教育的受试者<20分,接受≥7年教育的受试者<24分。高血压患者中MCI的患病率显著高于非高血压患者(22.1%对16.1%,P<.001),血压未得到控制的高血压患者中的患病率高于血压得到控制的患者(27.5%对20.7%,P = .01)。与非高血压患者相比,高血压患者的MMSE各项得分及总分显著更低。收缩压和舒张压与MMSE评分之间存在显著负相关(所有P<.001)。多因素逻辑回归分析显示,高血压是MCI存在的显著危险因素(OR = 1.62,95%CI:1.34,2.35,P<.001),独立于性别、年龄、教育程度和血脂异常等因素。高血压人群中MCI的患病率更高,且高血压是欠发达地区MCI的独立危险因素,这表明应对高血压患者进行MCI筛查,以便为认知功能下降的预防提供更好的诊断和最佳治疗,特别是在条件相近的地区。