Association of incident Alzheimer disease and blood pressure measured from 13 years before to 2 years after diagnosis in a large community study
Association of incident Alzheimer disease and blood pressure measured from 13 years before to 2 years after diagnosis in a large community study
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DOI：
10.1001/archneur.58.10.1640
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发表时间：
2001-10-01
影响因子：
--
通讯作者：
Evans, DA
中科院分区：
文献类型：
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作者：
Morris, MC;Scherr, PA;Evans, DA
背景：高血压是否会增加罹患阿尔茨海默病(AD)的风险尚不确定。目的：检验AD发病与确诊前长达13年的血压测量之间的关系。设计：1982-1988年间进行的纵向队列研究，在家庭访谈中每3年测量一次血压，1973年对部分样本(60%)进行测量。地点：东波士顿社区，马萨诸塞州参与者：在东波士顿建立的老年流行病学研究人群中，634名年龄在65岁或以上且没有AD的受试者被选为分层随机样本。主要观察指标：阿尔茨海默病是由神经科医生使用结构化的临床评估诊断的。结果：在调整了年龄、性别和教育水平的Logistic回归模型中，高血压与AD风险的增加无关。与诊断前13年测量的收缩压无相关性(优势比=1.03/10 mm Hg；95%可信区间0.80-1.32)，与诊断前4年测量的收缩压呈负相关(优势比=0.82/10 mm Hg；95%可信区间0.72-0.95)。舒张压的相关性与收缩压的相关性是相同的，只是有更宽的可信区间。在进一步调整心血管危险因素和疾病后，优势比没有实质性差异。结论：在这项大型社区研究中，高C、高血压与AD风险的增加无关。
Background: It is uncertain whether high blood pressure increases the risk of developing Alzheimer disease (AD).Objective: To examine the association between incident AD and blood pressure measured up to 13 years before diagnosis.Design: Longitudinal cohort study conducted from 1982 to 1988, with blood pressure measured every 3 years in home interviews, and in 1973 for a portion (60%) of the sample.Setting: Community of East Boston, Mass.Participants: Six hundred thirty-four subjects 65 years or older and without AD were selected as a stratified random sample of participants of the East Boston Established Populations for Epidemiologic Studies of the Elderly.Main Outcome Measure: Alzheimer disease was diagnosed by a neurologist using a structured clinical evaluation.Results: High blood pressure was not associated with an increased risk of AD in logistic regression models adjusted for age, sex, and level of education. There was no association with systolic pressure measured 13 years before diagnosis (odds ratio = 1.03/10 mm Hg; 95% confidence interval, 0.80-1.32) and an inverse association with systolic pressure measured 4 years before diagnosis (odds ratio = 0.82/10 mm Hg; 95% confidence interval, 0.72-0.95). Associations for diastolic pressure were in the same direction as those for systolic pressure except with wider confidence intervals. The odds ratios were not materially different with further adjustment for cardiovascular risk factors and diseases.Conclusion: In this large community study, high C, blood pressure was not associated with an increased risk of AD.