Orthostatic Hypotension and Cognitive Function: The Atherosclerosis Risk in Communities Study
Orthostatic Hypotension and Cognitive Function: The Atherosclerosis Risk in Communities Study
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DOI：
10.1159/000255459
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发表时间：
2010-01-01
影响因子：
5.7
通讯作者：
Gottesman, Rebecca F.
中科院分区：
文献类型：
--
作者：
Rose, Kathryn M.;Couper, David;Gottesman, Rebecca F.
背景：研究中年人直立性低血压与认知功能的关系。方法：参与者为12,702名来自社区动脉粥样硬化风险研究的男性和女性。OH定义为站立时收缩压(BP)下降20毫米汞柱或舒张压下降10毫米汞。在第2次和第4次追踪检查中，采用延迟性单词回忆测验、数字符号替代测验和词语流利性测验对认知功能进行评估。结果：经年龄调整后，与无OH组相比，有OH组更有可能处于DST(OR=1.34，95%CI=1.12~1.62)和WFT(OR=1.25，95%CI=1.03~1.51)的最低五分之一。在对社会人口和心血管危险因素进行调整后，相关性不再显著。仅在年龄调整的模型中，在第二次访问和第四次访问之间，OH与处于DSST评分下降最大五分之一的几率增加(OR=1.28，95%CI=1.04-1.58)。结论：···：···结论：OH与较差的认知功能有关，但这种关联主要归因于人口统计学和心血管危险因素。中年时的间歇性无症状低血压可能不是认知能力下降的独立原因。需要进一步的研究，包括重视神经成像。版权所有(C)2009 S.Karger AG，巴塞尔
Background: To examine the association between orthostatic hypotension (OH) and cognitive function in middle-aged adults. Methods: Participants were 12,702 men and women from the Atherosclerosis Risk in Communities Study. OH was defined as decrease in systolic blood pressure (BP) by >= 20 mm Hg or diastolic BP by >= 10 mm Hg upon standing. At the 2nd and the 4th follow-up examinations, cognitive function was assessed using the Delayed Word Recall Test, Digit Symbol Substitution Test (DSST) and Word Fluency Test (WFT). Results: After age adjustment, those with OH were more likely to be in the lowest quintile of the DSST (OR = 1.34, 95% CI = 1.12-1.62) and WFT (OR = 1.25, 95% CI = 1.03-1.51) than were those without OH. After adjustment for sociodemographic and cardiovascular risk factors, associations were no longer significant. In age-adjusted models only, OH was associated with increased odds of being in the greatest quintile of decline in DSST score between visits 2 and 4 (OR = 1.28, 95% CI = 1.04-1.58). Conclusions: OH was associated with less favorable cognitive function, but this association was largely attributable to demographic and cardiovascular risk factors. Episodic asymptomatic hypotension in middle age may not be an independent cause of cognitive decline. Further study, including emphasis on neuroimaging, is needed. Copyright (C) 2009 S. Karger AG, Basel