Does Gender Influence the Relationship Between High Blood Pressure and Dementia? Highlighting Areas for Further Investigation.
Does Gender Influence the Relationship Between High Blood Pressure and Dementia? Highlighting Areas for Further Investigation.
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DOI：
10.3233/jad-200245
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Nation DA
中科院分区：
文献类型：
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作者：
Blanken AE;Nation DA
在将血压与全因痴呆症以及两种最常见的痴呆症：阿尔茨海默病（AD）和血管性痴呆症（VaD）联系起来的研究中，已经注意到了性别差异。然而，性别如何改变血压和痴呆症之间的关系仍不清楚。回顾性别改变对血压和全因痴呆之间联系的影响的证据。根据PRISMA指南进行系统评价。256篇综述文章中有16篇符合纳入标准。对于女性，在七项研究中的六项研究中，中年收缩压（SBP）和高血压均与全因痴呆、AD和VaD的风险增加相关。其中两项研究报告，中年SBP/高血压与女性全因痴呆的风险增加相关，但与男性无关。一项研究报告，中年SBP较高与女性AD风险较高相关，但与男性无关。然而，另一项研究报告称，中年高血压与男性AD风险相关，但与女性无关。在晚年高血压/高血压与全因痴呆或AD之间的关系方面没有明确的性别差异。研究很少，而且不一致，分析或报告性别影响。因此，很难解释现有的关于性别在血压相关性痴呆中的作用的证据。几项研究表明，与男性相比，中年SBP较高与女性全因痴呆的风险更高相关。未来的研究应该在考虑血压和痴呆风险之间的联系时，评估中年女性特有的衰老过程。
Gender differences have been noted in studies linking blood pressure to all-cause dementia, and the two most common forms of dementia: Alzheimer’s disease (AD) and vascular dementia (VaD). However, how gender modifies the relationship between blood pressure and dementia remains unclear. To review evidence for a gender modifying effect on the link between blood pressure and all-cause dementia. A systematic review was conducted according to PRISMA guidelines. 16 out of 256 reviewed articles met inclusion criteria. For women, higher midlife systolic blood pressure (SBP) and hypertension were both associated with greater risk of all-cause dementia, AD and VaD, in six out of seven studies. Two of these studies reported higher midlife SBP/hypertension were associated with greater risk for all-cause dementia in women, but not men. One study reported higher midlife SBP associated with greater AD risk in women, but not men. However, another study reported that midlife hypertension associated with AD risk in men, but not women. No clear gender differences were reported in the relationship between late-life high blood pressure/hypertension with all-cause dementia or AD. Studies rarely, and inconsistently, analyzed or reported gender effects. Therefore, interpretation of available evidence regarding the role of gender in blood pressure associated dementia was difficult. Several studies indicated higher midlife SBP was associated with greater risk of all-cause dementia for women, compared to men. Future studies should evaluate women-specific aging processes that occur in midlife when considering the association between blood pressure and dementia risk.