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[未控制的高血压对中枢神经系统的影响]

[The impact of uncontrolled hypertension on the CNS].

作者信息

Tomek Aleš

出版信息

Vnitr Lek. 2023 Spring;69(2):105-108. doi: 10.36290/vnl.2023.017.

Abstract

The brain is a target of organ damage due to hypertension. In addition to acute damage in the form of hypertensive encephalopathy, ischaemic stroke, and intracerebral haemorrhage, hypertension causes chronic changes in the brain tissue that, over the course of years, will be manifested by impaired brain functions including cognitive deficit. Hypertension is also a risk factor for progression of cognitive disorder to overt dementia. It is commonly accepted that the earlier in life hypertension occurs, the greater the risk of developing dementia in old age. The pathophysiological mechanism underlying this effect of hypertension is microvascular damage which causes changes in the brain tissue and brain atrophy. A favourable fact is that the treatment with antihypertensive drugs demonstrably reduces the risk of developing dementia in individuals with hypertension. A more profound preventive effect was found in intensive blood pressure control and in RAAS system inhibitors. Therefore, hypertension has to be controlled since its onset, even in younger patients.

摘要

大脑是高血压导致器官损伤的靶器官。除了以高血压脑病、缺血性卒中和脑出血形式出现的急性损伤外,高血压还会引起脑组织的慢性变化,这些变化在数年的过程中会表现为包括认知缺陷在内的脑功能受损。高血压也是认知障碍进展为显性痴呆的危险因素。人们普遍认为,高血压发生的年龄越早,老年患痴呆症的风险就越大。高血压产生这种影响的病理生理机制是微血管损伤,它会导致脑组织变化和脑萎缩。一个有利的事实是,使用降压药物治疗可显著降低高血压患者患痴呆症的风险。在强化血压控制和肾素-血管紧张素-醛固酮系统(RAAS)抑制剂治疗中发现了更显著的预防效果。因此,即使在年轻患者中,高血压一旦发生就必须加以控制。

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