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高血压与不同认知障碍的关联。

Association of Hypertension with Different Cognitive Disorders.

作者信息

Huang Lillian, Aronow Wilbert S

机构信息

Department of Medicine, New York Medical College, Valhalla, NY 10595, USA.

Department of Cardiology, Westchester Medical Center, Valhalla, NY 10595, USA.

出版信息

J Clin Med. 2024 Oct 10;13(20):6029. doi: 10.3390/jcm13206029.

Abstract

This literature review explores the association between hypertension and major neurocognitive disorders, including delirium, Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, which contribute significantly to global mortality and morbidity. Hypertension is a potentially modifiable risk factor for cognitive decline, as it contributes to the progression of neurodegenerative pathologies via vascular damage, inflammation, and the disruption of the blood-brain barrier. Despite this, the effectiveness of antihypertensive treatments in preventing or alleviating cognitive decline remains contentious. While some research highlights the potential benefits of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, other studies show inconsistent results, complicated by variations in hypertension definitions, diagnostic criteria for cognitive disorders, and confounding factors like medication adherence. Furthermore, the complex bidirectional relationship between hypertension and major neurocognitive disorders warrants more investigation, as cognitive decline can exacerbate cardiovascular risks through heightened inflammatory responses and compromised autonomic regulation. This review underscores the need for prospective, long-term studies to elucidate the relationships between hypertension and cognitive disorders and to evaluate the potential therapeutic benefits of antihypertensive treatments.

摘要

这篇文献综述探讨了高血压与主要神经认知障碍之间的关联,这些障碍包括谵妄、阿尔茨海默病、血管性痴呆、路易体痴呆和额颞叶痴呆,它们对全球死亡率和发病率有重大影响。高血压是认知衰退的一个潜在可改变风险因素,因为它通过血管损伤、炎症和血脑屏障破坏导致神经退行性病变的进展。尽管如此,抗高血压治疗在预防或减轻认知衰退方面的有效性仍存在争议。虽然一些研究强调了血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂的潜在益处,但其他研究结果并不一致,这因高血压定义、认知障碍诊断标准以及药物依从性等混杂因素的差异而变得复杂。此外,高血压与主要神经认知障碍之间复杂的双向关系值得更多研究,因为认知衰退可通过增强炎症反应和自主调节受损加剧心血管风险。这篇综述强调需要进行前瞻性长期研究,以阐明高血压与认知障碍之间的关系,并评估抗高血压治疗的潜在治疗益处。

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