Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial.
Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial.
复制标题
执行轻度认知障碍中的降压治疗和脑血流动力学：试点随机临床试验的结果。
DOI：
10.1111/jgs.12100
复制
发表时间：
2013-02
影响因子：
6.3
通讯作者：
Lipsitz L
中科院分区：
文献类型：
--
作者：
Hajjar I;Hart M;Chen YL;Mack W;Novak V;C Chui H;Lipsitz L
在与高血压相关的认知能力下降的斗争中，抗高血压治疗对脑血流动力学的比较效果尚不清楚。比较调节肾素血管紧张素系统的抗高血压药物对患有执行功能障碍的高血压患者脑血流动力学和认知的影响。双盲随机临床试验。居住在社区的受试者年龄≥60 岁，患有高血压和执行功能障碍。赖诺普利、坎地沙坦或氢氯噻嗪治疗 1 年 在基线、6 个月和 12 个月时测量脑血流速度（休息、坐位、站立、高碳酸血症和低碳酸血症期间的经颅多普勒超声检查）、认知和血压。使用线性混合模型来比较三组。在 53 名参与者中，有 47 名成功进行声波治疗（平均年龄 = 72 岁；70% 为白人；57% 为女性）。坎地沙坦组有血流速度 (BFV) 增加的趋势，而赖诺普利或 HCTZ 组则有血流速度下降的趋势（组间 p 值 = 0.57）。这对于基线时 BFV 相对较低的人（<中位数 27.6 厘米/秒，组间 p 值 = 0.03）而言非常显着。坎地沙坦组的执行功能也有最大的改善（Trail Making Test，B 部分改善了 17.1 秒，而 HCTZ 改善了 4.2 秒，赖诺普利恶化了 14.4 秒，p=0.008）。赖诺普利组（血管反应性和血管舒缩范围的组内 p 值分别为 0.001 和 0.02）和 HCTZ 组（组内 p 值分别为 0.10 和 0.009）的 CO2 血管反应性和血管舒缩范围显着下降，但坎地沙坦组则没有显着下降（组内 p 值分别为 0.25 和 0.38；组间） p 值分别= 0.3 和 0.46）。这项初步研究表明，血管紧张素受体阻滞剂可能会优先保护脑血流动力学并改善执行功能障碍患者的执行功能。这些发现值得在更大规模的试验中进一步调查。
The comparative effects of antihypertensive therapy on cerebral hemodynamics in the contest of cognitive decline related to hypertension are unknown. To compare antihypertensive medicationsthat modulate the renin angiotensin system in cerebral hemodynamic and cognitive effects in hypertensive individuals with executive dysfunction. double-blind randomized clinical trial. Community-dwelling Subjects were ≥60 years with hypertension and executive dysfunction. lisinopril, candesartan, or hydrochlorothiazide for 1 year Cerebral blood flow velocity (Transcranial Doppler ultrasonography during rest, sitting, standing, hypercapnia, and hypocapnia), cognition and blood pressure were measured at baseline, 6 and 12 months. Linear mixed models were used to compare the3 groups. Of the 53 enrolled, 47 had successful insonation (mean age=72 years; 70% white; 57% women). There was a tendency for increased blood flow velocity (BFV) in the candesartan groupcompared to a decline in the lisinopril or HCTZ groups (between group p-value =0.57). This was significant in those with relative low BFV at baseline (<median 27.6 cm/sec, between group p-value =0.03). The candesartan group also had the greatest improvement in executive function (Trail Making Test, part B improved by 17.1 seconds vs HCTZ improved by 4.2 seconds and lisinopril worsened by 14.4 seconds, p=0.008). CO2-vasoreactivity and vasomotor range significantly declined in the lisinopril (within-group p-value=0.001 and 0.02 for vasoreactivity and vasomotor range) and HCTZ groups (within-group p-value=0.10 and 0.009 respectively) but not in the candesartan group (within-group p-value=0.25 and 0.38 respectively; between-group p-values= 0.3 and 0.46 respectively). This pilot study suggests that angiotensin receptor blockers may preferentially preserve cerebral hemodynamics and improved executive function in those with executive dysfunction. These findings warrant further investigation in a larger trial.
登录
查看更多内容
影响因子：
37.8
作者：
Hajjar I;Quach L;Yang F;Chaves PH;Newman AB;Mukamal K;Longstreth W Jr;Inzitari M;Lipsitz LA
通讯作者：
Lipsitz LA
影响因子：
4.2
作者：
Kobayashi, Tomonori;Kawamata, Takakazu;Hori, Tomokatsu
通讯作者：
Hori, Tomokatsu
影响因子：
8.3
作者：
Ghiadoni, L;Virdis, A;Salvetti, A
通讯作者：
Salvetti, A
影响因子：
6.3
作者：
Poels, Marielle M. F.;Ikram, Mohammad Arfan;Breteler, Monique M. B.
通讯作者：
Breteler, Monique M. B.
影响因子：
8.3
作者：
Rompe, Franziska;Artuc, Metin;Steckelings, U. Muscha
通讯作者：
Steckelings, U. Muscha