Reduced cerebral blood flow in older men with higher levels of blood pressure.
Reduced cerebral blood flow in older men with higher levels of blood pressure.
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DOI：
10.1097/hjh.0b013e328335c34f
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发表时间：
2010-05
影响因子：
4.9
通讯作者：
Katzel L
中科院分区：
文献类型：
--
作者：
Waldstein SR;Lefkowitz DM;Siegel EL;Rosenberger WF;Spencer RJ;Tankard CF;Manukyan Z;Gerber EJ;Katzel L
检查老年男性和女性血压 (BP) 与单光子发射计算机断层扫描 (SPECT) 得出的脑血流量估计值之间的关系。 74 名无中风和痴呆症的社区老年人（年龄 54-83 岁；68% 男性；91% 白人），无重大内科、神经或精神疾病，参与 a) 静息收缩压和舒张压的临床评估； b) 评估脑萎缩的磁共振成像（MRI）； c) 通过计算机化皮质编码和选择皮质下感兴趣区域 (ROI) 进行大脑 SPECT 研究。鉴于血压和性别对于多个 SPECT 结果的显着相互作用，计算了性别分层多元回归模型。模型根据年龄、空腹血糖水平、抗高血压药物、体重指数和脑萎缩的 MRI 评级进行了调整。在男性 (n = 50) 中，较高水平的收缩压和/或舒张压与左右额叶、颞叶、顶叶和枕叶皮层、丘脑、尾状核和扣带皮层的脑灌注估计值较低显着相关，占这些测量值方差的高达 28% (p < .05)。在女性 (n= 24) 中，较高的舒张压与右侧颞叶皮层较高的灌注水平略有相关 (p = .05)。在本样本中，在其他方面健康的老年男性中，较高的静息收缩压或舒张压与较低水平的脑灌注相关，但与女性无关。脑血流量减少可能会增加中风、痴呆和/或认知能力下降的风险，尤其是患有高血压的老年男性。
Examine relations of blood pressure (BP) to single photon emission computed tomography (SPECT)-derived estimates of cerebral blood flow in older men and women. Seventy-four stroke and dementia-free, community-dwelling older adults (ages 54–83; 68% men; 91% White) free of major medical, neurological, or psychiatric disease, engaged in a) clinical assessment of resting systolic and diastolic BP; b) magnetic resonance imaging (MRI) rated for brain atrophy; and c) brain SPECT studies with computerized coding of cortical and select subcortical regions of interest (ROIs). Given significant interactions of BP and sex with respect to multiple SPECT outcomes, sex-stratified multiple regression models were computed. Models were adjusted for age, fasting glucose levels, antihypertensive medication, body mass index, and MRI ratings of brain atrophy. In men (n= 50), higher levels of systolic and/or diastolic BP were associated significantly with lower estimates of cerebral perfusion in the right and left frontal, temporal, parietal, and occipital cortex, thalamus, head of caudate and cingulate cortex accounting for up to 28% of the variance in these measures (p’s < .05). In women (n= 24), higher diastolic BP related marginally to higher levels of perfusion in the right temporal cortex (p = .05). Higher resting systolic or diastolic BP was associated with lower levels of cerebral perfusion in otherwise healthy older men, but not women, in the present sample. Reduced cerebral blood flow may play a pathogenic role in increasing risk for stroke, dementia, and or cognitive decline particularly among older men with high blood pressure.
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