Elias M F, Wolf P A, D'Agostino R B, Cobb J, White L R
Department of Psychology, University of Maine, Orono 04469.
Am J Epidemiol. 1993 Sep 15;138(6):353-64. doi: 10.1093/oxfordjournals.aje.a116868.
It was hypothesized that blood pressure would be inversely related to cognitive functioning, if unconfounded with antihypertensive medication and measured over many occasions prior to neuropsychological testing. For stroke-free Framingham Study participants aged 55-88 years (n = 1,702), blood pressure levels were averaged over five biennial examinations (1956-1964) when few hypertensives were being treated, and examined in relation to neuropsychological tests administered between 1976 and 1978. With age, education, occupation, cigarette smoking, alcohol consumption, and gender controlled, blood pressure levels and chronicity of hypertension were inversely related to the composite score and measures of attention and memory. This was true for the full sample, for a subsample untreated during blood pressure measurement (n = 1,485), and for a subsample untreated throughout the entire study period (n = 1,038). For example, decline per 10 mmHg increment in blood pressure ranged from -0.04 to -0.07 standard score units (z) for the composite score. A negative finding previously was most likely due to blood pressure measurement concurrently with neuropsychological testing, or too few measurements. Hypertension-associated pathogenic processes may cause mild cognitive impairment, but other mechanisms need to be considered.
研究假设，如果在神经心理学测试之前的多个场合进行血压测量，且不受抗高血压药物干扰，那么血压将与认知功能呈负相关。对于年龄在55 - 88岁的无中风弗雷明汉研究参与者（n = 1702），在很少有高血压患者接受治疗时，通过五次两年一次的检查（1956 - 1964年）对血压水平进行平均，并与1976年至1978年期间进行的神经心理学测试相关联进行检查。在控制了年龄、教育程度、职业、吸烟、饮酒和性别因素后，血压水平和高血压的病程与综合评分以及注意力和记忆力的测量结果呈负相关。这在整个样本、血压测量期间未接受治疗的子样本（n = 1485）以及整个研究期间都未接受治疗的子样本（n = 1038）中均成立。例如，血压每升高10 mmHg，综合评分的下降幅度在 - 0.04至 - 0.07标准分数单位（z）之间。先前的负面研究结果很可能是由于在进行神经心理学测试的同时测量血压，或者测量次数过少。高血压相关的致病过程可能导致轻度认知障碍，但还需要考虑其他机制。
