High blood pressure, hypertension, and high pulse pressure are associated with poorer cognitive function in persons aged 60 and older: The Third National Health and Nutrition Examination Survey
High blood pressure, hypertension, and high pulse pressure are associated with poorer cognitive function in persons aged 60 and older: The Third National Health and Nutrition Examination Survey
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DOI：
10.1111/j.1532-5415.2007.01592.x
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发表时间：
2008-03-01
影响因子：
6.3
通讯作者：
Gillum, Richard Frank
中科院分区：
文献类型：
--
作者：
Obisesan, Thomas Olabode;Obisesan, Odunayo Abiodun;Gillum, Richard Frank
目的：验证高血压、高血压和高脉压（PP）与认知功能低下独立相关的假设。设计：对1988年至1994年接受调查的人进行横断面研究。研究对象：美国非收容人群。参与者：参加第三次全国健康和营养检查调查（NHANES III）的60岁及以上的6163名男性和女性。测量：测量包括血压、简易便携式精神状态检查（sp-MMSE）、自我报告的高血压史、诊断和治疗。结果：在60 ~ 64岁、65 ~ 69岁和70 ~ 74岁年龄组的初始双变量分析中，最佳血压（< 120/80 mmHg）与最佳认知表现相关；在所有年龄组中，重度高血压组的表现最差，但老年组（>= 80）表现相反，最佳血压组表现最差，中度高血压组表现最好。在以sp-MMSE为结果变量的多元回归分析中，这种模式略有变化。根据高血压预防、检测、评估和治疗全国联合委员会的报告，高血压和高PP在70 - 79岁和80岁及以上人群的认知能力比正常血压差。在60至69岁的受试者中没有发现显著的负相关。在控制了年龄、性别、种族、收入和血压等因素后，接受治疗但未得到控制的高血压患者的sp-MMSE评分明显低于没有高血压或高血压得到控制的患者。结论：在70岁及以上年龄，高血压、高血压和未得到控制的血压与认知功能较差相关。随着人口老龄化，血压的最佳控制可能有助于保护神经认知能力的丧失。
OBJECTIVES: To test the hypothesis that hypertension, high blood pressure, and high pulse pressure (PP) are independently associated with lower cognitive function.DESIGN: Cross-sectional study of persons examined in 1988 to 1994.SETTING: U.S. noninstitutionalized population.PARTICIPANTS: Six thousand one hundred sixty-three men and women aged 60 and older who participated in the Third National Health and Nutrition Examination Survey (NHANES III).MEASUREMENTS: Measurements included blood pressure, short-portable Mini-Mental State Examination (sp-MMSE), self-reported history of hypertension, diagnosis, and treatment.RESULTS: In the initial bivariate analysis within age groups of 60 to 64, 65 to 69, and 70 to 74, optimal blood pressure ( < 120/80 mmHg) was associated with best cognitive performance; the severe hypertension group had the poorest performance in all age groups except the very old (>= 80), where the pattern was reversed, showing poorest performance in the optimal blood pressure group and best in the group with moderate hypertension. This pattern changed slightly in multiple regression analyses modeling sp-MMSE as the outcome variable. Higher stage of hypertension according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and higher PP were associated with worse cognitive performance than normal blood pressure at ages 70 to 79 and 80 and older. No significant negative association was seen in subjects aged 60 to 69. Subjects with treated but uncontrolled hypertension had significantly lower sp-MMSE scores than those without hypertension or with controlled hypertension after controlling for age, sex, ethnicity, income, and PP.CONCLUSION: At age 70 and older, high blood pressure, hypertension, and uncontrolled blood pressure are associated with poorer cognitive function than normal blood pressure. Optimal control of blood pressure may be useful in preserving neurocognitive loss as the population ages.