Hypertension is related to cognitive impairment - A 20-year follow-up of 999 men
Hypertension is related to cognitive impairment - A 20-year follow-up of 999 men
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DOI：
10.1161/01.hyp.31.3.780
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发表时间：
1998-03-01
期刊：
影响因子：
8.3
通讯作者：
Lithell, H
中科院分区：
文献类型：
--
作者：
Kilander, L;Nyman, H;Lithell, H
近年来发现高血压与痴呆的发生发展之间存在联系，这为高血压脑靶器官损害的研究提供了新的前景，并为“可预防的衰老”的概念增添了内容。“本研究的目的是分析高血压、昼夜血压曲线和糖代谢紊乱对认知功能的影响。研究人群包括999名来自瑞典乌普萨拉的基于人群的队列研究的70岁男性，从50岁开始随访心血管危险因素。在70岁时，监测24小时动态血压，同时测量胰岛素敏感性、糖耐量、血脂和脂蛋白。认知功能通过简易精神状态检查和连线测验进行评估。基线舒张压高预测后期？配对的认知表现，即使排除了先前中风的男性（n=70）。70岁时的横截面测量显示，24小时高血压，非下降。胰岛素抵抗和糖尿病都与认知功能低下有关。高血压和认知障碍之间的关系在未经治疗的男性中最强。这些来自健康老年男性的数据表明，高血压和相关的代谢紊乱可能是认知障碍的易感因素。这些发现增加了对认知能力下降早期阶段（即在明显痴呆之前）进行干预的可能性的支持。
Recent findings of a linkage between high blood pressure (BP) and later development of dementia have given new prospects on cerebral target-organ damage in hypertension and have added substance to the concept of "preventable senility." The aim of this study was to analyze the impact of hypertension, circadian BP profile, and disturbed glucose metabolism on cognitive function. The study population consisted of 999 seventy-year-old men from a population-based cohort study in Uppsala, Sweden, followed with respect to cardiovascular risk factors since the age of 50 years. Ar the age of 70, 24-hour ambulatory BP was monitored together with measurements of insulin sensitivity, glucose tolerance, serum lipids, and lipoproteins. Cognitive function was assessed by the Mini-Mental State Examination and the Trail-Making Test. High diastolic BP at baseline predicted later in?paired cognitive performance, even after excluding men with a previous stroke (n=70). Cross-sectional measurements at age 70 showed that high 24-hour BP, nondipping. insulin resistance, and diabetes all were related to low cognitive function. The relationships between hypertension and cognitive impairment were strongest in untreated men. These data from a general population of healthy elderly men indicate that hypertension and associated metabolic disturbances might be susceptibility factors for cognitive disorders. The findings add support to possibilities of intervention in early stages in cognitive decline, ie, before manifest dementia.