Midlife vascular risk factors and Alzheimer's disease in later life:: longitudinal, population based study
Midlife vascular risk factors and Alzheimer's disease in later life:: longitudinal, population based study
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DOI：
10.1136/bmj.322.7300.1447
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发表时间：
2001-06-16
影响因子：
105.7
通讯作者：
Nissien, A
中科院分区：
文献类型：
--
作者：
Kivipelto, M;Helkala, EL;Nissien, A
目的 研究中年血压升高和血清胆固醇浓度与晚年患阿尔茨海默病的关系。
设计 前瞻性、基于人群的研究。
地点 芬兰东部的库奥皮奥和约恩苏的人群。
参与者 参与者来自1972年、1977年、1982年或1987年进行的一项调查中先前研究的基于人群的随机样本。经过平均21年的随访，1998年共有1449名（73%）年龄在65 - 79岁的参与者参加了复查。
主要观察指标 中年血压和胆固醇浓度以及晚年阿尔茨海默病的发生情况。
结果 中年收缩压升高（≥160 mmHg）或血清胆固醇浓度高（≥6.5 mmol/L）的人，即使在调整了年龄、体重指数、教育程度、血管事件、吸烟状况和饮酒量后，晚年患阿尔茨海默病的风险也显著高于收缩压正常（比值比2.3，95%置信区间1.0 - 5.5）或血清胆固醇正常（比值比2.1，1.0 - 4.4）的人。中年同时具有这两种危险因素的参与者患阿尔茨海默病的风险显著高于仅有其中一种危险因素的参与者（比值比3.5，1.6 - 7.9）。中年舒张压对阿尔茨海默病的风险没有显著影响。
结论 中年收缩压升高和血清胆固醇浓度高，特别是这些风险因素的组合，会增加晚年患阿尔茨海默病的风险。
Objective To examine the relation of midlife raised blood pressure and serum cholesterol concentrations to Alzheimer's disease in later life.Design Prospective, population based study.Setting Populations of Kuopio and Joensuu, eastern Finland.Participants Participants were derived from random, population based samples previously studied in a survey carried out in 1972, 1977, 1982, or 1987. After an average of 21 years' follow up, a total of 1449 (73%) participants aged 65-79 took part in the re-examination in 1998.Main outcome measures Midlife blood pressure and cholesterol concentrations and development of Alzheimer's disease in later life.Results People with raised systolic blood pressure (greater than or equal to 160 mm Hg) or high serum cholesterol concentration (greater than or equal to6.5 mmol/l) in midlife had a significantly higher risk of Alzheimer's disease in later life, even after adjustment for age, body mass index, education, vascular events, smoking status, and alcohol consumption, than those with normal systolic blood pressure (odds ratio 2.3, 95% confidence interval 1.0 to 5.5) or serum cholesterol (odds ratio 2.1, 1.0 to 4.4). Participants with both of these risk factors in midlife had a significantly higher risk of developing Alzheimer's disease than those with either of the risk factors alone (odds ratio 3.5, 1.6 to 7.9). Diastolic blood pressure in midlife had no significant effect on the risk of Alzheimer's disease.Conclusion Raised systolic blood pressure and high serum cholesterol concentration, and in particular the combination of these risks, in midlife increase the risk of Alzheimer's disease in later life.