Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses
Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses
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DOI：
10.3389/fepid.2023.1095236
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发表时间：
2023-02
期刊：
影响因子：
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通讯作者：
Jacob Brain;Leanne Greene;E. Tang;J. Louise;A. Salter;S. Beach;Deborah Turnbull;M. Siervo;B. C. Stephan;P. Tully
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文献类型：
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作者：
Jacob Brain;Leanne Greene;E. Tang;J. Louise;A. Salter;S. Beach;Deborah Turnbull;M. Siervo;B. C. Stephan;P. Tully
心血管疾病（CVD）与痴呆症风险增加有关;但证据是混合的。这篇综述批判性地评估和综合了目前的证据，探索痴呆风险和CVD及其危险因素之间的关联，包括冠心病，心力衰竭，房颤，高血压，高血压和动脉硬化。方法检索MEDLINE、Embase、PsycINFO和科克伦系统评价数据库，以确定系统评价和荟萃分析，研究至少一种感兴趣的心血管疾病与痴呆风险之间的关系。使用Joanna Briggs研究所（JBI）系统评价关键评价检查表评估方法学质量。结果纳入了2007年至2021年间发表的25项荟萃分析。研究主要包括来自北美和欧洲的队列。研究结果是可变的，冠心病，心力衰竭和房颤始终与全因痴呆的风险增加相关，但结果与阿尔茨海默病不一致。与晚年相比，中年高血压更常与痴呆相关。关于胆固醇的发现是复杂的，虽然低密度脂蛋白胆固醇和总胆固醇的结果不一致，但甘油三酯和高密度脂蛋白胆固醇之间似乎没有关联。所有研究高胆固醇血症的荟萃分析均显示痴呆风险显著增加。关于动脉僵硬度和痴呆风险之间的关系的研究很少。结论有针对性的CVD痴呆预防策略可以降低痴呆患病率。未来的研究应该确定心脏和大脑健康的基础机制，以确定降低CVD人群痴呆风险的最有效策略。
Introduction Cardiovascular diseases (CVDs) have been associated with an increased risk of dementia; yet the evidence is mixed. This review critically appraises and synthesises current evidence exploring associations between dementia risk and CVD and their risk factors, including coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and arterial stiffness. Methods MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews with meta-analyses investigating the association between at least one of the CVDs of interest and dementia risk. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews was used to assess methodological quality. Results Twenty-five meta-analyses published between 2007 and 2021 were included. Studies largely consisted of cohorts from North America and Europe. Findings were variable, with coronary heart disease, heart failure, and atrial fibrillation consistently associated with increased risk for all-cause dementia, but results were inconsistent for Alzheimer's disease. Hypertension was more frequently associated with dementia during mid-life compared to late life. Findings concerning cholesterol were complex, and while results were inconsistent for low-density lipoprotein cholesterol and total cholesterol, there appeared to be no associations between triglycerides and high-density lipoprotein cholesterol. All meta-analyses investigating hypercholesterolaemia showed significant increases in dementia risk. There was a paucity of research on the association between arterial stiffness and dementia risk. Conclusion Targeted CVD dementia prevention strategies could reduce dementia prevalence. Future research should determine the underpinning mechanisms linking heart and brain health to determine the most effective strategies for dementia risk reduction in CVD populations.