Department of Internal Medicine and Cognitive Health Services Research Program, University of Michigan, Ann Arbor, MI, USA.
Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA.
J Alzheimers Dis. 2022;89(3):1103-1117. doi: 10.3233/JAD-220366.
Ethnic differences in cognitive decline have been reported. Whether they can be explained by differences in systolic blood pressure (SBP) is uncertain.
Determine whether cumulative mean SBP levels explain differences in cognitive decline between Hispanic and White individuals.
Pooled cohort study of individual participant data from six cohorts (1971-2017). The present study reports results on SBP and cognition among Hispanic and White individuals. Outcomes were changes in global cognition (GC) (primary), executive function (EF) (secondary), and memory standardized as t-scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1 SD difference in cognition. Median follow-up was 7.7 (Q1-Q3, 5.2-20.1) years.
We included 24,570 participants free of stroke and dementia: 2,475 Hispanic individuals (median age, cumulative mean SBP at first cognitive assessment, 67 years, 132.5 mmHg; 40.8% men) and 22,095 White individuals (60 years,134 mmHg; 47.3% men). Hispanic individuals had slower declines in GC, EF, and memory than White individuals when all six cohorts were examined. Two cohorts recruited Hispanic individuals by design. In a sensitivity analysis, Hispanic individuals in these cohorts had faster decline in GC, similar decline in EF, and slower decline in memory than White individuals. Higher time-varying cumulative mean SBP was associated with faster declines in GC, EF, and memory in all analyses. After adjusting for time-varying cumulative mean SBP, differences in cognitive slopes between Hispanic and White individuals did not change.
We found no evidence that cumulative mean SBP differences explained differences in cognitive decline between Hispanic and White individuals.
已有研究报告称，认知能力下降存在种族差异。但这些差异是否可以用收缩压（SBP）的差异来解释尚不清楚。
确定累积平均 SBP 水平是否可以解释西班牙裔和白种人群认知能力下降的差异。
这是一项对六个队列（1971-2017 年）的个体参与者数据进行的汇总队列研究。本研究报告了西班牙裔和白种人群的 SBP 与认知之间的结果。结局为全球认知（GC）（主要结局）、执行功能（EF）（次要结局）和记忆的变化，以 t 评分标准化（均值[标准差]，50[10]）；相差 1 个点代表认知相差 0.1 个标准差。中位随访时间为 7.7（1/4-3/4，5.2-20.1）年。
共纳入 24570 名无卒中和痴呆的参与者：2475 名西班牙裔个体（中位年龄，首次认知评估时的累积平均 SBP，67 岁，132.5mmHg；40.8%为男性）和 22095 名白种个体（60 岁，134mmHg；47.3%为男性）。当考察所有六个队列时，西班牙裔个体的 GC、EF 和记忆下降速度均慢于白种个体。有两个队列是通过设计纳入西班牙裔个体的。在一项敏感性分析中，这些队列中的西班牙裔个体的 GC 下降速度较快，EF 下降速度相似，记忆下降速度较慢。所有分析中，较高的时间变化累积平均 SBP 与 GC、EF 和记忆的下降速度加快有关。在调整时间变化累积平均 SBP 后，西班牙裔和白种个体的认知斜率差异没有改变。
我们没有发现累积平均 SBP 差异可以解释西班牙裔和白种个体认知能力下降差异的证据。
