Department of Neurology, National Hospital Organization Maizuru Medical Center, 2410 Yukinaga, Maizuru, Kyoto, 625-8502, Japan.
Department of Neurology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
BMC Neurol. 2022 Apr 11;22(1):137. doi: 10.1186/s12883-022-02666-6.
Growing evidence suggests that vascular risk factors, especially hypertension, relate not only to cardiovascular disease but also to cognitive impairment. However, the impact of pulse pressure on cognitive function remains controversial. In this study, we evaluated the associations between pulse pressure and cognitive function in a Japanese health examination cohort using propensity matching analysis.
We examined 2,546 individuals with a mean age of 60.8 ± 10.3 years who voluntarily participated in health examination. Clinical variables included pulse pressure, and brain magnetic resonance imaging (MRI). We divided the participants into the high and low pulse pressure groups with a pre-defined cut-off value of 65 mmHg and evaluated their physical examination data, cognitive functions including Okabe's test, Kohs' test, and silent brain lesions using propensity matching. To clarify whether pulse pressure and blood pressure have different implications for cognitive function, a mediating analysis was also conducted.
From the 2,546 subjects, 439 (17.2%) were in the high PP group. The propensity matching algorithm produced 433 pairs of patients with similar propensities. Higher pulse pressure corresponded to lower Okabe and Kohs' scores (44.3 ± 7.1 vs 42.7 ± 7.5; p = 0.002, 97.9 ± 18.0 vs 95.0 ± 18.1 p = 0.019, respectively). The relationship between pulse pressure and cognitive impairment was not significantly mediated by systolic blood pressure. We observed no significant associations between silent brain lesions and pulse pressure.
High pulse pressure was associated with lower cognitive performance without systolic blood pressure mediation in Japanese subjects without dementia.
越来越多的证据表明，血管危险因素，尤其是高血压，不仅与心血管疾病有关，还与认知障碍有关。然而，脉压对认知功能的影响仍存在争议。在这项研究中，我们使用倾向评分匹配分析评估了日本健康检查队列中脉压与认知功能之间的关系。
我们检查了 2546 名平均年龄为 60.8±10.3 岁的自愿参加健康检查的个体。临床变量包括脉压和脑磁共振成像（MRI）。我们将参与者分为高脉压组和低脉压组，以 65mmHg 的预定义截断值，并使用倾向评分匹配评估他们的体检数据、认知功能，包括冈部测试、科氏测试和无声脑损伤。为了阐明脉压和血压对认知功能的影响是否不同，我们还进行了中介分析。
在 2546 名受试者中，有 439 名（17.2%）受试者处于高脉压组。倾向评分匹配算法产生了 433 对具有相似倾向的患者。较高的脉压与较低的冈部和科氏评分相关（44.3±7.1 比 42.7±7.5；p=0.002，97.9±18.0 比 95.0±18.1；p=0.019）。脉压与认知障碍之间的关系不受收缩压的显著中介。我们没有观察到无声脑损伤与脉压之间存在显著关联。
在没有痴呆的日本人群中，高脉压与认知功能下降有关，而不受收缩压的中介。
