Treatment of hypertension reduces cognitive decline in older adults: a systematic review and meta-analysis.
Treatment of hypertension reduces cognitive decline in older adults: a systematic review and meta-analysis.
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DOI：
10.1136/bmjopen-2020-038971
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发表时间：
2020-11-17
期刊：
影响因子：
2.9
通讯作者：
Gronseth G
中科院分区：
文献类型：
--
作者：
Gupta A;Perdomo S;Billinger S;Beddhu S;Burns J;Gronseth G
目的：系统分析高血压药物治疗对老年人认知功能减退的影响。随机、安慰剂对照试验，具有预先指定的认知量化结果和至少12个月的药物干预，用于治疗老年人(60岁)的HTN。我们的主要结果是HTN药物治疗后认知功能的改变。采用标准化平均差值(SMD)分析所选研究报告的不同结果。我们检索了PubMed Central和Cochrane图书馆，时间从最初到2020年7月6日。两名独立审查员评估了试验质量并提取了数据。对研究的内部和外部有效性进行了评估。最终分析包括9个随机对照试验，34994名参与者。认知改变的净SMD值为−0.049(CI：−0.078至−0.019)，表明HTN的治疗减少了认知能力的下降。异质性较低，指数为6%。目前的证据并不表明HTN的治疗会使认知功能恶化。对老年人进行HTN治疗可能会减少认知功能衰退。这些结果对痴呆症高危患者的临床治疗具有重要意义。CRD42020139750。
To systematically analyse the effect of pharmacological treatment of hypertension (HTN) on cognitive decline in older adults. Randomised, placebo-controlled trials with a prespecified quantitative outcome of cognition and a pharmacological intervention for at least 12 months to treat HTN in older adults (>60 years). Our primary outcome was change in cognition with pharmacological treatment of HTN. Standardised mean difference (SMD) was used to analyse different outcomes reported in the selected studies. We searched PubMed CENTRAL and the Cochrane Library from inception to 6 July 2020. Two independent reviewers assessed trial quality and extracted data. Internal and external validity of the studies was assessed. Nine randomised controlled trials with 34 994 participants were included in the final analysis. The net SMD for change in cognition was −0.049 (CI: −0.078 to −0.019) indicating that treatment of HTN decreased cognitive decline. Heterogeneity was low with an I² of 6%. Current evidence does not indicate worsening of cognition with treatment of HTN. Treatment of HTN in older adults may reduce cognitive decline. These results have important implications in clinical management of patients at risk for dementia. CRD42020139750.
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