Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
J Alzheimers Dis. 2024;99(2):485-488. doi: 10.3233/JAD-240032.
Midlife cerebrovascular risk factors increase risk of late life cognitive impairment and dementia, while their presence in patients with dementia may lead to cognitive improvement or stabilization in late life. Defining the best measure of blood pressure (BP) to be associated with cognitive decline remains debatable, also due to possible bidirectionality. BP variability, pulse pressure, systolic and diastolic BP have been associated with cognitive status, dementia risk and Alzheimer's disease biomarkers. Proper BP control notwithstanding, BP variability increases risk for pathophysiological change in the Alzheimer's disease continuum, implying the need for selection of anti-hypertensive drugs with neurobiological evidence of benefits.
中年脑血管危险因素会增加晚年认知障碍和痴呆的风险，而在痴呆患者中，这些危险因素的存在可能导致晚年认知能力的改善或稳定。由于可能存在双向关系，因此，确定与认知能力下降相关的最佳血压（BP）测量方法仍存在争议。血压变异性、脉压、收缩压和舒张压与认知状态、痴呆风险和阿尔茨海默病生物标志物有关。尽管进行了适当的血压控制，但血压变异性增加了阿尔茨海默病连续体发生病理生理变化的风险，这意味着需要选择具有神经生物学获益证据的抗高血压药物。
