Blood pressure variability supersedes heart rate variability as a real-world measure of dementia risk.
Blood pressure variability supersedes heart rate variability as a real-world measure of dementia risk.
复制标题
DOI：
10.1038/s41598-024-52406-8
复制
发表时间：
2024-01-22
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
在严格对照的研究中，血压变异性(BPV)和心率变异性(HRV)与阿尔茨海默病和相关痴呆(ADRD)有关。然而，BPV和HRV在多大程度上可以在现实世界的常规临床护理中提供预测性信息尚不清楚。在一项对48,204名在单一中心接受持续护理的成年人(年龄54.9 ±HRV17.5岁，女性占60%)进行的回溯性队列研究中，我们从常规收集的临床数据中得出了BPV和 。我们使用多变量COX模型来评估BPV和HRV分别和联合与事件ADRD的相关性。在中位数3[2.4，3.0]年中，有443例新发ADRD病例。我们发现，临床上测量的BPV，而不是HRV，与ADRD事件一致相关。在联合分析中，只有BPV最高四分位数和HRV最低四分位数的患者ADRD风险增加(HR 2.34，95%CI 1.44-3.81)。这些结果表明，临床得出的BPV，而不是HRV，为现实世界患者护理环境中的ADRD风险评估提供了一个一致且容易获得的指标。因此，BPV作为一种广泛使用的工具的实施可以使临床提供者有效地识别最有可能从全面的ADRD筛查中受益的患者。
Blood pressure variability (BPV) and heart rate variability (HRV) have been associated with Alzheimer’s Disease and Related Dementias (ADRD) in rigorously controlled studies. However, the extent to which BPV and HRV may offer predictive information in real-world, routine clinical care is unclear. In a retrospective cohort study of 48,204 adults (age 54.9 ± 17.5 years, 60% female) receiving continuous care at a single center, we derived BPV and HRV from routinely collected clinical data. We use multivariable Cox models to evaluate the association of BPV and HRV, separately and in combination, with incident ADRD. Over a median 3 [2.4, 3.0] years, there were 443 cases of new-onset ADRD. We found that clinically derived measures of BPV, but not HRV, were consistently associated with incident ADRD. In combined analyses, only patients in both the highest quartile of BPV and lowest quartile of HRV had increased ADRD risk (HR 2.34, 95% CI 1.44–3.81). These results indicate that clinically derived BPV, rather than HRV, offers a consistent and readily available metric for ADRD risk assessment in a real-world patient care setting. Thus, implementation of BPV as a widely accessible tool could allow clinical providers to efficiently identify patients most likely to benefit from comprehensive ADRD screening.
登录
查看更多内容
影响因子：
15.1
作者：
通讯作者：
--
影响因子：
9.9
作者：
Foster, Norman L.;Bondi, Mark W.;Wang, David
通讯作者：
Wang, David
影响因子：
5.7
作者：
Burkard, Thilo;Mayr, Michael;Vischer, Annina Salome
通讯作者：
Vischer, Annina Salome
影响因子：
39
作者：
Drawz, Paul E.;Agarwal, Anil;Pajewski, Nicholas M.
通讯作者：
Pajewski, Nicholas M.
影响因子：
2.6
作者：
Barnett JH;Lewis L;Blackwell AD;Taylor M
通讯作者：
Taylor M