Influence of Baseline Diastolic Blood Pressure on the Effects of Systolic Blood Pressure Lowering on Cognitive Function in Type 2 Diabetes Mellitus.
Influence of Baseline Diastolic Blood Pressure on the Effects of Systolic Blood Pressure Lowering on Cognitive Function in Type 2 Diabetes Mellitus.
复制标题
基线舒张压对收缩压降低对 2 型糖尿病认知功能的影响。
DOI：
10.1093/ajh/hpac118
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发表时间：
2023
影响因子：
3.2
通讯作者：
Beddhu,Srinivasan
中科院分区：
文献类型：
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作者：
Gupta,Aditi;Boucher,Robert;Wei,Guo;Gronseth,Gary;Parks,Adam;Beddhu,Srinivasan
研究背景降低舒张压（DBP）低的患者的收缩压（SBP），可进一步降低DBP.这可能会降低脑灌注和认知能力。我们研究了基线DBP对降低SBP对cognition.MethodsThis的影响的影响，这是一个事后分析的记忆在糖尿病（MIND）子研究（N= 1,430）的行动，以控制糖尿病心血管风险（雅阁）研究（NCT 00000620）。在基线和第20个月和第40个月进行标准神经心理学测试（数字符号替代测试[DSST]、简易精神状态检查[MMSE]、Rey听觉语言学习测试[RAVLT]和Stroop测试）。我们比较了密集（目标SBP <120毫米汞柱）与标准（目标SBP <140毫米汞柱）SBP控制的影响，在4个测试分数的变化，从基线的平均值为20个月和40整个范围内的基线DBP使用三次样条terms.ResultsMean age为63 ± 6岁，55%是女性和66%白色。基线DBP较低的患者年龄较大，心血管事件较多，糖尿病持续时间较长。在强化与标准SBP干预中，DSST（−0.22; 95% CI −0.97，0.52）、MMSE（−0.14; 95% CI −0.34，0.06）、RAVLT（−0.12; 95% CI −0.29，0.06）和Stroop干扰（−0.47; 95% CI −1.76，0.82）的变化无差异。基线DBP和SBP intervention.ConclusionsIntensive SBP降低分数变化之间没有相互作用，即使在基线DBP较低的患者中，也不会对认知产生不利影响。
BackgroundLowering of systolic blood pressure (SBP) in patients with low diastolic blood pressure (DBP), can further lower DBP. This can potentially decrease cerebral perfusion and cognition. We examined the influence of baseline DBP on the effect of lowering SBP on cognition.MethodsThis is apost hocanalysis of the Memory in Diabetes (MIND) substudy (N= 1,430) of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study (NCT00000620). Standard neuropsychological tests (Digit Symbol Substitution Test [DSST], Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [RAVLT], and Stroop test) were performed at baseline and months 20 and 40. We compared the effects of intensive (goal SBP <120 mm Hg) vs. standard (goal SBP <140 mm Hg) SBP control on the changes in the 4 test scores from baseline to the averages of months 20 and 40 across the range of baseline DBP using cubic spline terms.ResultsMean age was 63 ± 6 years, 55% were women and 66% White. Participates with lower baseline DBP were older, had more cardiovascular events and a longer duration of diabetes. There was no difference in the change in DSST (−0.22; 95% CI −0.97, 0.52), MMSE (−0.14; 95% CI −0.34, 0.06), RAVLT (−0.12; 95% CI −0.29, 0.06), and Stroop interference (−0.47; 95% CI −1.76, 0.82) in the intensive vs. standard SBP intervention. There was no interaction between baseline DBP and change in scores with the SBP intervention.ConclusionsIntensive SBP reduction does not adversely affect cognition, even in those with low baseline DBP.