Mone Pasquale, Pansini Antonella, Calabrò Francesco, De Gennaro Stefano, Esposito Mafalda, Rinaldi Paolo, Colin Antonio, Minicucci Fabio, Coppola Antonio, Frullone Salvatore, Santulli Gaetano
Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York City, NY, USA.
University Campania "Luigi Vanvitelli", Naples, Italy.
J Clin Hypertens (Greenwich). 2022 May;24(5):638-643. doi: 10.1111/jch.14439. Epub 2022 Mar 1.
P-Wave Dispersion (PWD) is an ECG parameter defined as the difference between the longest and the shortest P-Wave duration. PWD has been associated with hypertension, a leading cause of age-related cognitive decline. Moreover, hypertension is associated with vascular dementia and Alzheimer's Disease. Based on these considerations, we evaluated PWD and global cognitive function in frail hypertensive older adults with a previous diagnosis of cognitive decline. We evaluated consecutive frail hypertensive patients ≥65-year-old with a Mini-Mental State Examination (MMSE) score <26. Patients with evidence of secondary hypertension, history of stroke, myocardial infarction, or therapy with beta-blockers or acetylcholinesterase inhibitors were excluded. Beta-blocker therapy causes a significant decrease in PWD; patients treated with acetylcholinesterase inhibitors were not included to avoid confounding effects on cognitive function. By examining 180 patients, we found that PWD significantly correlated with MMSE score. Strikingly, these effects were confirmed in a linear multivariate analysis with a regression model. To our knowledge, this is the first study showing that PWD correlates with global cognitive function in frail hypertensive older adults.
P波离散度(PWD)是一种心电图参数,定义为最长与最短P波时限之间的差值。PWD与高血压有关,高血压是与年龄相关的认知衰退的主要原因。此外,高血压与血管性痴呆和阿尔茨海默病有关。基于这些考虑,我们评估了先前诊断为认知衰退的体弱高血压老年人的PWD和整体认知功能。我们评估了连续的年龄≥65岁、简易精神状态检查表(MMSE)评分<26分的体弱高血压患者。排除有继发性高血压证据、中风病史、心肌梗死病史或接受β受体阻滞剂或乙酰胆碱酯酶抑制剂治疗的患者。β受体阻滞剂治疗会使PWD显著降低;未纳入接受乙酰胆碱酯酶抑制剂治疗的患者,以避免对认知功能产生混杂影响。通过对180名患者的检查,我们发现PWD与MMSE评分显著相关。令人惊讶的是,在使用回归模型的线性多变量分析中证实了这些效应。据我们所知,这是第一项表明PWD与体弱高血压老年人的整体认知功能相关的研究。