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JAMA Neurol：血压控制与老年认知障碍

2017-08-24 zhangfan MedSci原创

血压控制老年认知障碍
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对于70岁以下需进行降压治疗的人群，收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险，该结果对于黑人人群尤为显著

第八届全国医药联合委员会(JNC-8)推荐对于70岁以上的老年人群收缩压应控制在150mmHg以内，而收缩压干预试验(SPRINT)则建议老年人群的收缩压控制在120mmHg以下以降低心血管事件风险。目前所有的血压控制指南均为涉及患者的认知功能结果，近日研究人员对收缩压与认知功能之间的关系进行了考察。

1997-2017年间，1657名认知正常的老年人接受高血压治疗。研究人员通过4次精神状态检查 (3MSE)以及5次数字符号替换测验(DSST)考察参与者的认知功能。根据患者血压分层：120mmHg以下；129-139mmHg；140-149mmHg以及150mmHg以上，采用混合模型评估收缩压水平与10年认知轨迹变化。

研究期间，不同收缩压水平患者的认知评分差距显著减少，但150mmHg以上组患者的认知评分减少最为显著(3MSE评分3.7；DSST评分6.2)，120mmHg以下组患者的认知评分变化最少(3MSE评分3.0；DSST评分5.0)。与白人相比，黑人群体血压对认知功能的影响更为显著，150mmHg以上组与120mmHg以下组认知评分差异，3MSE评分：白人vs黑人，-0.05 vs-0.08； DSST评分：白人vs黑人，-0.07 vs-0.13。

研究认为，对于70岁以下需进行降压治疗的人群，收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险，该结果对于黑人人群尤为显著。

原始出处：


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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-10-15 yinhl1978

    #Neurol#

    0

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    2017-08-28 ylzr123

    认真学习.不断进步.把经验分享给同好.点赞了!

    0

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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-26 gj0733

    #血压控制#

    0

  4. 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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 海棠胜雪

    学习了

    0

  5. 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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 meiliwuxian

    学习一下

    0

  6. 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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 baihao215

    spirit的纳入标准还是有讲究地

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri Aug 25 06:40:49 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236834, encodeId=7e2423683420, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Aug 25 00:30:05 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236829, encodeId=efc023682923, content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 1391e9f2a7m

    学习了.谢谢分享

    0

  8. 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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 半夏微凉

    学习了谢谢分享

    0

  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri Aug 25 06:40:49 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236834, encodeId=7e2423683420, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Aug 25 00:30:05 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236829, encodeId=efc023682923, content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 飛歌

    学习了很有用不错

    0

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content=对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著., beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Aug 25 00:21:33 CST 2017, time=2017-08-25, status=1, ipAttribution=)]
    2017-08-25 随梦飞扬

    对于70岁以下需进行降压治疗的人群.收缩压控制在120mmHg以下可显著降低患者的认知功能障碍风险.该结果对于黑人人群尤为显著.

    0

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