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中年时期的长期血压模式与晚年痴呆症:弗雷明汉心脏研究的发现。

Long-term blood pressure patterns in midlife and dementia in later life: Findings from the Framingham Heart Study.

机构信息

Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA.

Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts, USA.

出版信息

Alzheimers Dement. 2023 Oct;19(10):4357-4366. doi: 10.1002/alz.13356. Epub 2023 Jul 2.

Abstract

INTRODUCTION

Long-term blood pressure (BP) measures, such as visit-to-visit BP variability (BPV) and cumulative BP, are strong indicators of cardiovascular risks. This study modeled up to 20 years of BP patterns representative of midlife by using BPV and cumulative BP, then examined their associations with development of dementia in later life.

METHODS

For 3201 individuals from the Framingham Heart Study, multivariate logistic regression analyses were performed to examine the association between long-term BP patterns during midlife and the development of dementia (ages ≥ 65).

RESULTS

After adjusting for covariates, every quartile increase in midlife cumulative BP was associated with a sequential increase in the risk of developing dementia (e.g., highest quartile of cumulative systolic blood pressure had approximately 2.5-fold increased risk of all-cause dementia). BPV was not significantly associated with dementia.

DISCUSSION

Findings suggest that cumulative BP over the course of midlife predicts risk of dementia in later life. HIGHLIGHTS Long-term blood pressure (BP) patterns are strong indicators of vascular risks. Cumulative BP and BP variability (BPV) were used to reflect BP patterns across midlife. High cumulative BP in midlife is associated with increased dementia risk. Visit-to-visit BPV was not associated with the onset of dementia.

摘要

简介

长期血压(BP)指标,如随访间血压变异性(BPV)和累积 BP,是心血管风险的强有力指标。本研究通过 BPV 和累积 BP 来模拟中年时期长达 20 年的 BP 模式,然后研究它们与晚年痴呆症发病的关系。

方法

对弗雷明汉心脏研究中的 3201 名个体进行多变量逻辑回归分析,以研究中年时期长期 BP 模式与痴呆症(年龄≥65 岁)发病之间的关系。

结果

在调整了协变量后,中年时期累积 BP 的每四分位增加与痴呆症发病风险的连续增加相关(例如,最高四分位的累积收缩压的全因痴呆风险增加约 2.5 倍)。BPV 与痴呆症无显著相关性。

讨论

研究结果表明,中年时期的累积 BP 预测晚年痴呆症的风险。

要点

长期血压(BP)模式是血管风险的有力指标。累积 BP 和 BP 变异性(BPV)用于反映中年时期的 BP 模式。中年时期的高累积 BP 与痴呆症风险增加相关。随访间 BPV 与痴呆症的发生无关。

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