A longitudinal study of mid-to late-life blood pressure profiles as risk factors for Alzheimer´s disease in Hispanics

一项关于西班牙裔中晚年血压状况作为阿尔茨海默病危险因素的纵向研究

• 批准号: 9334043
• 负责人: Gladys E. Maestre
• 金额: $ 7.91万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9334043
• 关键词: Activities of Daily Living; Address; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Ambulatory Blood Pressure Monitoring; Behavior; Behavioral; Blood Pressure; Cardiovascular Physiology; Cardiovascular system; Caribbean region; Cholesterol; Clinical; Clinical Trials; Cognition; Cognitive; Comorbidity; Complex; Consensus; Data; Data Analyses; Data Set; Databases; Dementia; Development; Diabetes Mellitus; Diagnosis; Diastolic blood pressure; Early Diagnosis; Educational Background; Elderly; Epidemiology; Evaluation; Family; Family member; Funding; Genome; Genotype; Geriatrics; Goals; Health; High Prevalence; Hispanics; Homocysteine; Hour; Hypertension; Incidence; Individual; Latin America; Latino; Life; Longitudinal Studies; Longitudinal cohort study; Measurement; Measures; Medical; Minority; Modernization; Neuroepidemiology; Neurologic; Neuropsychology; Not Hispanic or Latino; Onset of illness; Participant; Pattern; Phenotype; Physiological; Plasma; Population; Population Sciences; Positioning Attribute; Prevention; Prevention approach; Pulse Pressure; Records; Research; Resources; Risk; Risk Factors; Rosa; Series; Socioeconomic Factors; Source; Statistical Data Interpretation; Techniques; Time; Treatment outcome; United States National Institutes of Health; Vascular Diseases; base; cardiovascular disorder risk; cardiovascular health; cognitive function; cognitive performance; cohort; computerized; design; disease diagnosis; evidence base; experience; genetic analysis; high risk; improved; longitudinal analysis; longitudinal dataset; middle age; mild cognitive impairment; multidisciplinary; neuroimaging; phenotypic data; population based; pre-clinical; pressure; response; symposium; trait

SUMMARY Alzheimer´s disease (AD) has a high impact in the health of aging Hispanic populations. Several studies in the U.S. and Latin America and the Caribbean have shown higher rates of AD in Hispanics/Latinos than in their non-Hispanic counterparts. Further, AD onset occurs about 7 years earlier and is more often accompanied by systemic/cardiovascular comorbidities (e.g. hypertension, diabetes). Yet, few longitudinal studies have focused on AD in Hispanics, and the underlying causes of the differences between Hispanics and non-Hispanics are not well understood. In response to the PAR-15-350, we will focus in one of the most robust risk factors for AD that has not systematically been studied in Hispanic populations: hypertension in mid-life. The proposed research will exploit rich existing longitudinal cardiovascular and cognition data on the Hispanic cohort of the Maracaibo Aging Study (MAS), and the fact that blood pressure (BP) was measured with both, conventional – office-based, as well as ambulatory BP (ABPM) techniques in several occasions to analyze how mid- and late- life blood pressure (BP) traits, prior to onset of dementia, are related to AD incidence, onset, and progression. In Aim 1, we will evaluate the association between ABPM and conventional BP in mid- and late-life and AD by: 1) Populating a central database with a comprehensive set of longitudinal data for 2500 MAS participants, including conventional BP, ABPM, and other cardiovascular traits; cognitive, clinical, demographic, and behavioral phenotypes; and, 2) Examine the relationships between levels of BP components (e.g., SBP, DBP, MAP, PP) and AD-related phenotypes (e.g., neuropsychological score, age at onset) comparing ABPM vs. conventional BP, in mid- and late-life in a Hispanic population. In Aim 2, we will investigate how BP measures and dipping BP patterns at the first evaluation, and changes in BP measures over time are related to subsequent cognitive performance to better understand the clinical course of AD from a healthy state to mild cognitive impairment to AD. We will first perform the analysis using conventional BP, which has an average of 8.2 evaluations, and then will re-evaluate the relationships using ABPM to verify significant relationships from the analysis of conventional BP. To accomplish these goals, we will also leverage an expert multidisciplinary team with extensive experience in population science, neuroepidemiology, cardiovascular health, geriatrics, database development, and modern statistical techniques for the analysis of longitudinal data, who have ongoing experience working with Hispanic populations. Our findings will improve understanding of the long- term influence of BP traits during pre-clinical stages of dementia on later development of AD, and inform clinical trials to facilitate development of evidence-based strategies to improve prevention, early diagnosis, treatment, and outcomes, especially for Hispanics. Equally important, we will have built a valuable resource that will extend the current longitudinal studies on Hispanics and AD when the currently study is completed. !

概括 阿尔茨海默病 (AD) 对西班牙裔老龄化人口的健康影响很大。多项研究在 美国、拉丁美洲和加勒比地区的西班牙裔/拉美裔的 AD 发病率高于其他国家 非西班牙裔同行。此外，AD 发病时间大约为 7 年前，并且更常伴有 全身/心血管合并症（例如高血压、糖尿病）。然而，很少有纵向研究关注 西班牙裔人的AD，以及西班牙裔和非西班牙裔之间差异的根本原因是 不太理解。为了响应 PAR-15-350，我们将重点关注 AD 最强有力的风险因素之一 尚未在西班牙裔人群中进行系统研究：中年高血压。拟议的 研究将利用现有的关于西班牙裔人群的丰富的纵向心血管和认知数据 马拉开波衰老研究 (MAS)，以及血压 (BP) 是通过传统方法测量的 – 多次使用基于办公室的血压 (ABPM) 技术来分析中期和晚期的情况 痴呆症发病前的生活血压 (BP) 特征与 AD 的发病率、发作和进展有关。 在目标 1 中，我们将通过以下方式评估中晚年和 AD 中 ABPM 与传统血压之间的关联： 1) 使用 2500 名 MAS 参与者的一套全面的纵向数据填充中央数据库， 包括常规血压、动态血压和其他心血管特征；认知、临床、人口统计和 行为表型； 2) 检查血压各组成部分水平之间的关系（例如收缩压、舒张压、 MAP、PP）和 AD 相关表型（例如神经心理学评分、发病年龄）比较 ABPM 与 AD 相关表型（例如，神经心理学评分、发病年龄） 西班牙裔人群中年和晚年的传统血压。在目标 2 中，我们将研究 BP 如何测量 和第一次评估时血压下降模式，以及血压测量随时间的变化与 随后的认知表现，以更好地了解 AD 从健康状态到轻度的临床过程 AD 认知障碍。我们首先使用传统 BP 进行分析，其平均值为 8.2 评估，然后使用 ABPM 重新评估关系，以验证来自 常规BP分析。为了实现这些目标，我们还将利用多学科专家 团队在人口科学、神经流行病学、心血管健康、老年医学、 数据库开发和用于纵向数据分析的现代统计技术，谁拥有 与西班牙裔人群一起工作的持续经验。我们的研究结果将增进对长期 痴呆临床前阶段血压特征对 AD 后期发展的长期影响，并提供信息 临床试验，以促进制定基于证据的策略，以改善预防、早期诊断、 治疗和结果，特别是对于西班牙裔。同样重要的是，我们将建立宝贵的资源 当当前研究完成时，这将扩展当前对西班牙裔和 AD 的纵向研究。 ！

项目成果

Starting Antihypertensive Drug Treatment With Combination Therapy: Controversies in Hypertension - Con Side of the Argument.

• DOI: 10.1161/hypertensionaha.120.12858
• 发表时间: 2021-03-03
• 期刊: Hypertension (Dallas, Tex. : 1979)
• 作者: Zhang ZY;Yu YL;Asayama K;Hansen TW;Maestre GE;Staessen JA
• 通讯作者: Staessen JA

An improved statistical model for taxonomic assignment of metagenomics.

• DOI: 10.1186/s12863-018-0680-1
• 发表时间: 2018-10-29
• 期刊: BMC genetics
• 影响因子: 2.9
• 作者: Yao Y;Jin Z;Lee JH
• 通讯作者: Lee JH

Basic anthropometry and health status of elderly: findings of the Maracaibo Aging Study.

老年人的基本人体测量学和健康状况：马拉开波老龄化研究的结果。

• DOI: 10.1177/0898264309357444
• 发表时间: 2010
• 期刊: Journal of aging and health
• 影响因子: 2.8
• 作者: Muñoz,AngélicaM;Falque-Madrid,Luis;Zambrano,RaquelCh;Maestre,GladysE
• 通讯作者: Maestre,GladysE

Two-year neurocognitive responses to first occupational lead exposure.

• DOI: 10.5271/sjweh.3940
• 发表时间: 2021-04-01
• 期刊: Scandinavian journal of work, environment & health
• 作者: Yu YL;Thijs L;Saenen N;Melgarejo JD;Wei DM;Yang WY;Yu CG;Roels HA;Nawrot TS;Maestre GE;Staessen JA;Zhang ZY
• 通讯作者: Zhang ZY