Cacciatore F, Abete P, Ferrara N, Paolisso G, Amato L, Canonico S, Maggi S, Varricchio M, Rengo F
Cattedra di Geriatria, Università degli Studi di Napoli Federico II, Italy.
J Hypertens. 1997 Feb;15(2):135-42. doi: 10.1097/00004872-199715020-00003.
The aim of this study was to investigate the cross-sectional relationship between arterial blood pressure and cognitive impairment in a group of elderly subjects, controlling for such confounding variables as age, education, depression, drug use and antihypertensive treatment.
A cross-sectional survey in Campania, a region in southern Italy.
A random sample of 1339 elderly subjects aged 65-95 years (mean 73.9 +/- 6.2 years) selected from the electoral rolls was interviewed by trained physicians. Sociodemographic characteristics, results of Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), blood pressure and whether antihypertensive treatment was being administered were recorded. When subjects with neurological diseases and those under psychotropic therapy were excluded from the analyses, the population numbered 1106.
The MMSE score was less than 24 for 27.9% of the subjects and the mean GDS score was 10.8 +/- 6.3. The mean systolic blood pressure (SBP) was 145.3 +/- 19.0 mmHg and the mean diastolic blood pressure (DBP) was 82.0 +/- 9.2 mmHg. Logistic regression analysis showed that female sex, age, GDS score and DBP but not SBP were predictive of cognitive impairment. Educational level and antihypertensive treatment, on the contrary, play a protective role. DBP was associated with cognitive impairment in subjects aged 75 years (odds ratio 1.62, 95% confidence interval 1.16-2.25) and over (odds ratio 5.16, 95% confidence interval 1.50-17.71) but not in those aged 65-74 years.
DBP but not SBP is predictive of cognitive impairment in subjects aged 75 years and over without neurological disorders independently from sex, age, education, GDS and antihypertensive treatment
本研究旨在调查一组老年受试者动脉血压与认知障碍之间的横断面关系，同时控制年龄、教育程度、抑郁、药物使用和抗高血压治疗等混杂变量。
在意大利南部坎帕尼亚地区进行的横断面调查。
从选民名单中随机抽取1339名年龄在65 - 95岁（平均73.9±6.2岁）的老年受试者，由经过培训的医生进行访谈。记录社会人口学特征、简易精神状态检查表（MMSE）结果、老年抑郁量表（GDS）、血压以及是否正在进行抗高血压治疗。当将患有神经系统疾病和接受精神药物治疗的受试者排除在分析之外时，研究人群为1106人。
27.9%的受试者MMSE评分低于24分，GDS平均评分为10.8±6.3。平均收缩压（SBP）为145.3±19.0 mmHg，平均舒张压（DBP）为82.0±9.2 mmHg。逻辑回归分析表明，女性、年龄、GDS评分和DBP而非SBP可预测认知障碍。相反，教育程度和抗高血压治疗起到保护作用。DBP与75岁及以上（比值比1.62，95%置信区间1.16 - 2.25）受试者的认知障碍相关，但与65 - 74岁受试者无关。
对于75岁及以上无神经系统疾病的受试者来说，舒张压而非收缩压可独立于性别、年龄、教育程度、GDS和抗高血压治疗预测认知障碍。
