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中年及老年轻度认知障碍患者高血压的病程、治疗、控制与生活方式危险因素之间的关联:一项病例对照研究

The Association Between the Duration, Treatment, Control of Hypertension and Lifestyle Risk Factors in Middle-Aged and Elderly Patients with Mild Cognitive Impairment: A Case-Control Study.

作者信息

Yan Xiwu, Meng Ting, Liu Huaijun, Liu Jinfeng, Du Juan, Chang Cheng

机构信息

Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People's Republic of China.

Key Laboratory of Cognitive Impairment Research, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2022 Mar 19;18:585-595. doi: 10.2147/NDT.S353164. eCollection 2022.

Abstract

BACKGROUND

Epidemiological studies suggest that the incidence of hypertension in China is causally related to cognitive impairment. However, there is a dearth of information available regarding important factors for the association, including disease duration, therapeutic options, and risk factors associated with mild cognitive impairment (MCI) in patients with hypertension.

METHODS

We selected a diverse cohort of 572 patients with hypertension and assessed cognitive function using MoCA. Potential risk factors were investigated by a structured questionnaire. Risk factors associated with the hypertension-induced MCI occurring conversion of were analyzed using multifactorial regression analysis.

RESULTS

MCI was observed in 256 of 572 individuals, which increased with age (OR=1.15, 95% CI 1.10-1.20), but was decreased with high education status (OR=0.47, 95% CI 0.32-0.71). Risk factors independently associated with MCI were diabetes (OR=2.40, 95% CI 1.53-3.76), hyperlipidemia (OR=1.49, 95%=1.01-2.16), high salt diet (OR=2.27, 95% CI 1.34-3.84), and physical activity:>2h/week (OR=0.65, 95%0.44-0.94). However, controlling blood pressure to "normal" target values helped decrease the incidence of MCI (OR=0.44, 95% CI 0.30-0.65): this was not age dependent.

CONCLUSION

Our results suggest that it is necessary to promote the education of the middle-aged and elderly Chinese population to correctly and effectively use anti-hypertensives to control hypertension to a normal range to prevent cognitive.

摘要

背景

流行病学研究表明,中国高血压的发病率与认知障碍存在因果关系。然而,关于这种关联的重要因素,包括病程、治疗选择以及高血压患者轻度认知障碍(MCI)相关的危险因素,目前可用信息匮乏。

方法

我们选取了572名高血压患者组成的多样化队列,使用蒙特利尔认知评估量表(MoCA)评估认知功能。通过结构化问卷调查潜在危险因素。采用多因素回归分析,分析与高血压所致MCI发生转化相关的危险因素。

结果

572名个体中有256人观察到MCI,其随年龄增加(比值比[OR]=1.15,95%置信区间[CI]1.10 - 1.20),但随高学历状态降低(OR=0.47,95%CI 0.32 - 0.71)。与MCI独立相关的危险因素有糖尿病(OR=2.40,95%CI 1.53 - 3.76)、高脂血症(OR=1.49,95%=1.01 - 2.16)、高盐饮食(OR=2.27,95%CI 1.34 - 3.84)以及每周体育活动>2小时(OR=0.65,95%0.44 - 0.94)。然而,将血压控制在“正常”目标值有助于降低MCI的发病率(OR=0.44,95%CI 0.30 - 0.65):这与年龄无关。

结论

我们的结果表明,有必要促进中国中老年人群的教育,使其正确有效地使用抗高血压药物将高血压控制在正常范围,以预防认知障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb38/8942123/f05b6dcb309f/NDT-18-585-g0001.jpg

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