Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2023 Mar 15;18(3):e0281532. doi: 10.1371/journal.pone.0281532. eCollection 2023.
Patients with hypertension are at higher risk for dementia than the general population. We sought to understand the relative importance of various risk factors in the development of dementia among patients with hypertension. This population-based cohort study used data from the Korean National Insurance Service database. Using the Cox proportional hazard model, R2 values for each potential risk factor were calculated to test the relative importance of risk factors for the development of dementia. Eligible individuals were adults 40 to 79 years of age with hypertension and without a history of stroke and dementia between 2007 and 2009. A total of 650,476 individuals (mean age, 60 ± 11 years) with hypertension were included in the analyses. During a mean follow-up of 9.5 years (±2.8 years), 57,112 cases of dementia were observed. The three strongest predictors of dementia were age, comorbidity burden (assessed using the Charlson Comorbidity Index), and female sex (R2 values, 0.0504, 0.0023, and 0.0022, respectively). The next strongest risk factors were physical inactivity, smoking, alcohol consumption, and obesity (R2 values, 0.00070, 0.00024, 0.00021, and 0.00020, respectively). Across all age groups, physical inactivity was an important risk factor for dementia occurrence. In summary, controlling and preventing comorbidities are of utmost importance to prevent dementia in patients with hypertension. More efforts should be taken to encourage physical activity among patients with hypertension across all age groups. Furthermore, smoking cessation, avoiding and limiting alcohol consumption, and maintaining an appropriate body weight are urged to prevent dementia.
高血压患者患痴呆症的风险高于一般人群。我们试图了解各种风险因素在高血压患者痴呆症发展中的相对重要性。这项基于人群的队列研究使用了韩国国家医疗保险数据库的数据。使用 Cox 比例风险模型，计算每个潜在风险因素的 R2 值，以测试风险因素对痴呆症发展的相对重要性。合格的个体为 2007 年至 2009 年间年龄在 40 至 79 岁之间、无中风和痴呆症病史的高血压成年人。共有 650476 名（平均年龄 60 ± 11 岁）高血压患者纳入分析。在平均 9.5 年（±2.8 年）的随访期间，观察到 57112 例痴呆病例。痴呆症的三个最强预测因素是年龄、合并症负担（使用 Charlson 合并症指数评估）和女性性别（R2 值分别为 0.0504、0.0023 和 0.0022）。其次是身体活动不足、吸烟、饮酒和肥胖（R2 值分别为 0.00070、0.00024、0.00021 和 0.00020）。在所有年龄组中，身体活动不足是痴呆发生的重要危险因素。总之，控制和预防合并症对预防高血压患者的痴呆症至关重要。应更加努力鼓励所有年龄段的高血压患者进行身体活动。此外，应鼓励戒烟、避免和限制饮酒以及保持适当的体重，以预防痴呆症。
