Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study.
Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study.
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DOI：
10.1186/s13195-017-0262-x
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发表时间：
2017-05-31
期刊：
影响因子：
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通讯作者：
Holmen J
中科院分区：
文献类型：
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作者：
Gabin JM;Tambs K;Saltvedt I;Sund E;Holmen J
由于流行病学研究报告了相互矛盾的证据，血压和痴呆症的关系引起了很多关注。观察数据表明，中年高血压是晚年认知能力下降和痴呆的危险因素，而有证据表明，低血压是晚年的预测因素。本研究的目的是检查痴呆症与确定之前 27 年（平均 17.6 年）测量的血压之间的关联。在挪威北特伦德拉格县，我们收集了 1995 年至 2011 年期间发生的痴呆症数据，并由该领域的专家小组验证了诊断结果。通过使用受试者的个人身份证号码，痴呆症数据与 Nord-Trøndelag 健康研究（HUNT 研究）的数据相关联，这是一项于 1984-1986 年（HUNT 1）和 1995-1997 年（HUNT 2）进行的大型人群健康研究。本研究共纳入了 24,638 名 HUNT 研究参与者，其中 579 人被诊断患有阿尔茨海默病、混合型阿尔茨海默/血管性痴呆或血管性痴呆。我们进行了多重逻辑回归分析，以分析痴呆与 HUNT 1 和 HUNT 2 的血压数据之间的关联。在 60 岁以上的人群中，在调整年龄、性别、教育程度和其他相关协变量时，观察到收缩压与全因痴呆、混合性阿尔茨海默/血管性痴呆和阿尔茨海默病之间存在一致的负相关，但与血管性痴呆之间不存在相关。无论是否使用抗高血压药物，在 HUNT 1 和 HUNT 2 中均观察到收缩压。在 60 岁以下接受抗高血压药物治疗的个体中，收缩压、脉压和阿尔茨海默病之间存在负相关。我们的数据与之前的研究结果一致，这些研究表明 60 岁以上人群的痴呆症与收缩压之间呈负相关。然而，我们不能排除生存效应。在中年受试者（<60 岁）中，收缩压和脉压升高与报告使用抗高血压药物的个体最终患上阿尔茨海默病有关。本文的在线版本 (doi:10.1186/s13195-017-0262-x) 包含补充材料，可供授权用户使用。
A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment. In Nord-Trøndelag County, Norway, incident dementia data were collected during 1995–2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects’ personal identification numbers, the dementia data were linked to data from the Nord-Trøndelag Health Study (the HUNT Study), a large, population-based health study performed in 1984–1986 (HUNT 1) and 1995–1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2. Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years. Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in individuals over the age of 60 years. We cannot exclude a survival effect, however. Among middle-aged subjects (<60 years), elevated systolic blood pressure and pulse pressure were associated with eventual Alzheimer disease in individuals who reported using antihypertensive medication. The online version of this article (doi:10.1186/s13195-017-0262-x) contains supplementary material, which is available to authorized users.