Lutchman Yuvthi, Mahajan Rajiv, Cosh Suzanne M, Harris Katie, Tzourio Christophe, Tully Phillip J
School of Psychology, The University of New England, Australia.
Adelaide Medical School, The University of Adelaide, Australia.
Cereb Circ Cogn Behav. 2024 Jun 7;6:100228. doi: 10.1016/j.cccb.2024.100228. eCollection 2024.
Blood pressure variability (BPV) impacts brain health by influencing brain structure and cerebrovascular pathologies, though the mechanisms are poorly understood. Changes in the cerebrovasculature may lead to late-onset depression, cognitive impairment, and dementia, however the relationship between BPV with depression and anxiety remains unclear, due to methodological differences and inconsistencies in past research. This review aims to clarify the association between BPV with depression and anxiety in adults to inform understandings of the mechanisms implicating BPV in cognitive health. A systematic search from inception through to January 2024 was performed on Embase, PubMed, PsycINFO, and Web of Science. Studies that assessed BPV quantified by beat-to-beat, 24-hour, or visit-to-visit were eligible if the standardised assessment of depression and/or anxiety were reported as a linear association, or mean differences across control and affect groups. A total of 14 articles reporting on 13 samples and = 5055 persons met the inclusion criteria (median female proportion = 61 %, range 0 % - 76 %). A meta-analysis was not possible due to methodological heterogeneity in BPV measurements and metrics across studies. Mixed results were observed across depression studies with inconsistencies and variation in the direction, strength of association, and BPV metric. There was weak evidence from only three studies to support a linear association between systolic coefficient of variation and anxiety. Collectively, the findings contribute to understanding the association between BPV and brain health, suggesting that any relationship between BPV and brain structures critical for cognitive function are independent of depression and only modestly implicate anxiety.
血压变异性（BPV）通过影响脑结构和脑血管病变来影响脑健康，但其机制尚不清楚。脑血管系统的变化可能导致迟发性抑郁、认知障碍和痴呆，然而，由于过去研究中的方法差异和不一致性，BPV与抑郁和焦虑之间的关系仍不明确。本综述旨在阐明成人中BPV与抑郁和焦虑之间的关联，以增进对BPV影响认知健康机制的理解。从创刊至2024年1月，我们在Embase、PubMed、PsycINFO和科学网进行了系统检索。如果报告了抑郁和/或焦虑的标准化评估为线性关联，或对照组与患病组之间的平均差异，则评估逐搏、24小时或就诊间量化的BPV的研究符合纳入标准。共有14篇文章报告了13个样本和5055人，符合纳入标准（女性比例中位数=61%，范围0%-76%）。由于各研究中BPV测量方法和指标的方法学异质性，无法进行荟萃分析。在抑郁研究中观察到的结果不一，关联方向、强度和BPV指标存在不一致和差异。仅有三项研究提供了微弱的证据支持收缩压变异系数与焦虑之间存在线性关联。总体而言，这些发现有助于理解BPV与脑健康之间的关联，表明BPV与对认知功能至关重要的脑结构之间的任何关系独立于抑郁，仅适度涉及焦虑。
