Yao Junxiu, Wang Shengshu, Li Meiling, Song Baomei, Lan Cong, Jia Jianjun, Yang Yongjian
Department of Cardiovascular Medicine, General Hospital of the Chinese People's Liberation Army Western Theater, Chengdu, China.
Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
PLoS One. 2025 Feb 5;20(2):e0317861. doi: 10.1371/journal.pone.0317861. eCollection 2025.
Hypertension is closely related to cognitive impairment; however, the correlation between blood pressure control and cognitive impairment in the hypertensive population is unclear. We aimed to explore the relationship between blood pressure control and cognitive impairment in older adults with hypertension. Using the cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, 5,860 people with self-reported history of hypertension were divided into the hypotension, intermediate blood pressure, and hypertension groups. Cognitive impairment was defined as a score of < 18 on the Chinese version of the Mini-Mental State Examination. Demographics of the population were also collected. Bivariate Logistic regression analysis and restricted cubic spline (RCS) model were used to analyze the relationship between blood pressure control and cognitive impairment. After adjusting for confounding factors, binary logistic regression analysis showed that the intermediate group was significantly associated with an increased risk of cognitive impairment than the hypotension group, whereas the hypertension group was significantly correlated with a reduced risk of cognitive impairment. No significant correlation was found between blood pressure control and cognitive impairment in patients aged <80 years, with hearing impairment, or with cerebrovascular diseases, whether in the hypotension or hypertension groups. There was a significant correlation between hypotension and cognitive impairment, and no correlation between hypertension and cognitive impairment in people aged ≥ 80 years, Han ethnicity and those who used antihypertensive drugs. Furthermore, RCS model analysis showed that there was a non-linear relationship between systolic blood pressure and cognitive impairment in individuals aged ≥ 80 years and those using antihypertensive drugs. There was a linear relationship between diastolic blood pressure and cognitive impairment. Blood pressure control in the hypertensive group was significantly associated with a lower risk of cognitive impairment.
高血压与认知障碍密切相关；然而，高血压人群中血压控制与认知障碍之间的相关性尚不清楚。我们旨在探讨老年高血压患者血压控制与认知障碍之间的关系。利用2018年中国健康与养老追踪调查的横断面数据，将5860名自述有高血压病史的人分为低血压组、血压正常组和高血压组。认知障碍定义为中文版简易精神状态检查表得分<18分。还收集了人群的人口统计学数据。采用二元逻辑回归分析和受限立方样条（RCS）模型分析血压控制与认知障碍之间的关系。在调整混杂因素后，二元逻辑回归分析显示，与低血压组相比，血压正常组与认知障碍风险增加显著相关，而高血压组与认知障碍风险降低显著相关。在年龄<80岁、有听力障碍或患有脑血管疾病的患者中，无论低血压组还是高血压组，血压控制与认知障碍之间均未发现显著相关性。在年龄≥80岁、汉族和使用降压药物的人群中，低血压与认知障碍之间存在显著相关性，而高血压与认知障碍之间无相关性。此外，RCS模型分析显示，在年龄≥80岁和使用降压药物的个体中，收缩压与认知障碍之间存在非线性关系。舒张压与认知障碍之间存在线性关系。高血压组的血压控制与较低的认知障碍风险显著相关。
