Prospective associations between pulse pressure and cognitive performance in Chinese middle-aged and older population across a 5-year study period.
Prospective associations between pulse pressure and cognitive performance in Chinese middle-aged and older population across a 5-year study period.
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DOI：
10.1186/s13195-018-0355-1
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发表时间：
2018-03-12
期刊：
影响因子：
--
通讯作者：
Yan Y
中科院分区：
文献类型：
--
作者：
Sha T;Cheng W;Yan Y
大量证据表明，血压（BP）测量和认知功能之间的关系是不一致的，复杂的，与年龄有关。脉压（Pulse pressure，PP）不仅能反映动脉硬化程度，而且能反映除血压本身以外的高血压的慢性效应，被认为是认知功能损害的较好预测指标。然而，关于认知功能与PP相关的证据尚未得到广泛研究。我们在一项基于潜在增长模型（LGM）的纵向研究中研究了这种关系。这项研究基于中国健康与退休纵向研究（CHARLS）的中国中老年参与者的全国代表性样本，CHARLS是一项2011年至2016年进行的前瞻性观察性研究。认知性能进行了评估的基础上的三个认知措施。PP计算为三次收缩压和舒张压读数的平均值之差。本研究收集了一系列潜在混杂因素。LGM被用来检查PP在三个时间点对认知性能的影响。为了检验PP对初始水平和随后的认知发展的独立影响，依次比较了无条件和条件模型。在排除了缺失关键变量的受访者后，我们最终纳入了9750名参与者。认知表现评分和PP随时间的推移显示出显著差异。在校正混杂因素后，LGM中PP的标准化系数表明，在波2和波3，中国老年人的认知能力受到负面影响（P < 0.01）。在无条件模型中，PP的初始水平与认知的初始水平（β =-0.25）和斜率（β =-0.16）呈负相关，而在控制混杂因素后，这些影响减弱，PP的截距与认知斜率之间的关联变得不显著。这些结果的影响表明，较高的PP降低了中老年人的认知性能独立的一套全面的协变量，但它不是一个贡献者的认知变化率。本文的在线版本（10.1186/s13195-018-0355-1）包含补充材料，可供授权用户使用。
Substantial evidence indicates that the relationship between blood pressure (BP) measures and cognitive functioning is inconsistent, complex, and age-related. Pulse pressure (PP), which can not only reflect arterial stiffness and but also represent the chronic effects of hypertension other than BP itself, has been considered as a better predictor of cognitive impairment. However, evidence on the association of cognitive function with PP has not been investigated extensively. We examined this relationship in a longitudinal study based on the latent growth model (LGM). This study was based on a nationally representative sample of Chinese middle-aged and older participants from the China Health and Retirement Longitudinal Study (CHARLS), a prospective observational study conducted from 2011 to 2016. Cognitive performance was assessed on the basis of three measures of cognition. The PP was calculated as the difference of the average values of three systolic and diastolic BP readings. A series of potential confounders were collected in this research. The LGM was used to examine the effects of PP on cognitive performance at three time points. To test the independent effects of PP on the initial level and the subsequent development of cognition, unconditional and conditional models were compared sequentially. After excluding respondents with missing key variables, we ultimately included 9750 participants in the analysis. Cognitive performance scores and PP showed significant differences across time. After adjustment for the confounders, the standardized coefficients of PP in the LGM indicated negative effects on cognitive performance in elderly Chinese participants at wave 2 and wave 3 (P < 0.01). The initial level of PP in the unconditional model was negatively associated with the initial level (β = − 0.25) and the slope (β = − 0.16) of cognition, whereas these effects were attenuated and the association between intercept of PP and slope of cognition became nonsignificant after controlling for the confounders. The implications of these results demonstrate that a higher PP lowers the cognitive performance of middle-aged and elderly persons independent of a comprehensive set of covariates, but it is not a contributor to the rate of change in cognition. The online version of this article (10.1186/s13195-018-0355-1) contains supplementary material, which is available to authorized users.
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