Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Department of Neurological Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
Alzheimers Dement. 2023 Jul;19(7):2966-2974. doi: 10.1002/alz.12935. Epub 2023 Jan 19.
We assessed the association between visit-to-visit blood pressure variability (BPV) up to 12 years and subsequent dementia risk, and tested the modifying effect of antihypertensive medications.
We studied 2234 participants from two community-based cohorts of older adults with normal cognition or mild cognitive impairment. Participants were followed through annual assessments for up to 27 years. Visit-to-visit BPV was quantified over 3, 6, 9, and 12 years, respectively.
Higher systolic BPV (SBPV) during 3, 6, 9, and 12 years was associated with a subsequent increased risk of dementia, with hazard ratios ranging from 1.02 (95% confidence interval [CI]: 1.01-1.04) to 1.10 (95% CI: 1.05-1.16). The association between SBPV and dementia risk was stronger among participants not taking calcium channel blockers (p-for interaction < 0.05).
Among older adults, long-term exposure to higher visit-to-visit SBPV is associated with an increased risk of dementia later in life, and calcium channel blockers may modify this association.
Among adults aged >65, higher systolic blood pressure variability spanning 3-12 years is associated with an increased risk of dementia later in life. Single blood pressure measurement or mean blood pressure levels does not seem to associate with dementia risk among older adults. The association between systolic blood pressure variability and dementia risk is stronger among those not taking calcium channel blocker medications.
我们评估了长达 12 年的随访血压变异性（BPV）与随后痴呆风险之间的关系，并检验了降压药物的修饰作用。
我们研究了来自两个基于社区的认知正常或轻度认知障碍的老年人群队列的 2234 名参与者。参与者通过每年的评估进行了长达 27 年的随访。分别评估了 3、6、9 和 12 年的随访 BPV。
3、6、9 和 12 年期间较高的收缩压 BPV（SBPV）与随后痴呆风险增加相关，风险比范围为 1.02（95%置信区间 [CI]：1.01-1.04）至 1.10（95%CI：1.05-1.16）。在未服用钙通道阻滞剂的参与者中（p 交互作用<0.05），SBPV 与痴呆风险之间的关联更强。
在老年人中，长期暴露于较高的随访 SBPV 与晚年痴呆风险增加相关，钙通道阻滞剂可能会修饰这种关联。
在年龄>65 岁的成年人中，3-12 年期间较高的收缩压变异性与晚年痴呆风险增加相关。单次血压测量或平均血压水平似乎与老年人的痴呆风险无关。SBPV 与痴呆风险之间的关联在未服用钙通道阻滞剂药物的人群中更强。
