Relationship between blood pressure level and cognitive impairment in patients with hypertension
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摘要: 目的:探讨高血压患者的收缩压、舒张压及脉压参数与其记忆功能的相关性,为进一步采取干预措施提供可靠依据。方法:收集唐山市工人医院高血压患者196例为观察组,应用英国Rivermead康复中心设计的行为记忆测验第2版(RBMT-Ⅱ,2003年)对其进行记忆功能测评;应用方差分析、线性相关和逐步回归分析检验收缩压、舒张压及脉压水平与记忆功能的相关性。结果:不同分级高血压患者的记忆障碍患病率及程度随着血压水平的提高而加重(χ2=28.696,P<0.01),高血压3级患者的RBMT-Ⅱ评分与高血压1、2级患者比较,在回忆姓名、回忆被藏物品、脸部再认、路线延迟回忆、定向单项评分及总标准分等6项评分均差异有统计学意义(均P<0.05);随着收缩压水平及脉压水平的升高,RBMT-Ⅱ评分呈下降趋势(P<0.05);舒张压水平与RBMT-Ⅱ评分无相关性。结论:高血压患者的收缩压参数及脉压参数影响记忆功能,尤其以脉压参数明显。应加强脉压参数的调节与控制,以维持和提高高血压患者的记忆功能。Abstract: Objective:To explore the relationship between systolic blood pressure(SBP),pulses pressure(PP),diastolic blood pressure(DBP) level and cognitive impairment in patients with hypertension,and provide credible foundation for interventions on cognitive impairment. Method:One hundred and ninety-six patients with hypertension in Tangshan Worker's Hospital were selected and surveyed with questionnaires.Cognitive function was measured by the Rivermead Behavioural Memory Test Second Edition(RBMT-Ⅱ,2003).The One-Way ANOVA and linear regression was used to find the statistical significance between SBP,PP,DBP level and cognitive impairment. Result:The morbidity of memory disorder among patients with hypertension was higher and more serious with increasing blood pressure level(χ2=28.696,P<0.01).Among different systolic pressure groups,RBMT-Ⅱ total scores,Recall name,Remember storing article,Recall faces,Delayed Route,orientation score decreased with increasing blood pressure level(P<0.05).Linear regression analysis showed that SBP,PP level were positively related to the morbidity of cognitive impairment(P<0.01),and there was no relationship between DBP level and the morbidity of cognitive impairment. Conclusion:The SBP level and PP level in patients with hypertension had significant impact on cognitive function.Especially the PP level impacted the cognitive function much more seriously.Lower the level of PP effectively is a strong determinant of lowering the morbidity of cognitive impairment.
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Key words:
- hypertension /
- cognitive impairment
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[1] TERVO S,KIVIPELTO M,HANNINEN T,et al.Incidence and risk factors for mild cognitive impairment:apopulation-based three-year follow-up study of cognitivelyhealthy elderly subjects[J].Dement Geriatr Cogn Disord,2004,17:196-203.
[2] MANLY J J,TANG M X,SCHUPF N,et al.Frequency and course of mild cognitive impairment in a multiethnic community[J].Ann Neurol,2008,63:494-506.
[3] 中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中华心血管病杂志,2011,39(7):579-616.
[4] 孟家眉.对脑卒中临床研究工作的建议(附件二),伴发疾病的积分(附件三)既往史的评分[J].中华神经精神杂志,1988,20():58-60.
[5] 郭华珍,恽小平.Rivermead行为记忆测验第2版介绍[J].中国康复理论与实践,2007,13(10):909-910.
[6] WILLS P,CLARE L,SHIEL A,et al.Assessingsubtle memory impairments in the everyday memoryperformance of brain injured people:exploring the potential of the Extended Rivermead Behavioural Memory Test[J].Brain Injury,2000,14:693-704.
[7] 陈谊.老年人高血压与认知功能障碍的关系[J].中国行为医学科学,2005,14(2):173-174.
[8] 刘忆星,陆兵勋,刘中华,等.高血压患者记忆障碍的临床研究[J].广东医学,2007,28(6):953-955.
[9] JULIE A,JESSE C,CHRISTOPHER R,et al.Therelationship between blood pressure and cognitive performance in the third national health and nutrition examination surgery(NHANESIII)[J].PsychosomMed,2004,66:291-297.
[10] RENPRECHT F,ELMSTAHL S,JANXON L,etal.Hypertension and changes of cognitive function in 82-year-old men:a 13-year follow-up of the population study"Men born in 1914",Sweden[J].Hyper-tension,2003,21:57-66.
[11] 吴寿领,王玉珍,李冬青,等.血压参数与老年人认知功能障碍的关系[J].中华高血压杂志,2007,15(8):661-664.
[12] TSIVGOULIS G,ALEXANDROV A V,WADLEYV G,et al.Association of higher diastolic blood pressure levels with cognitive impairment[J].Neurology,2009,73:589-595.
[13] 金文敏,张莉,容玉栋,等.老年原发性高血压患者脉压与靶器官损害的相关研究[J].临床内科杂志,2005,22(3):749-751.
[14] CERAVOLO R,MAIO R,PUJIA A,et al.Pulsepressure and endothelial dysfunction in never-treatedhypertensive patients[J].JACC,2003,41:1759-1760.
[15] QIU C,WINBLAD B,VITANEN M,et al.Pulsepressure and risk of Alzheimer disease in persons aged 75 years and olders:A community-based,longitudinalstudy[J].Stroke,2003,34:594-599.
[16] 陈长香,王静,赵雅宁,等.社区老年人记忆障碍的记忆训练处方干预效果研究[J].中华行为医学与脑科学杂志,2011,20(1):70-72.
[17] ZHANG M,KATZMAN P,SALMON D,et al.Prevalence of dementia and Alzheimer's disease inShanghai,China:impact of age,gender,and education[J].Ann Neurol,1990,27:428-437.
[18] CRUIKSHANK J M,THORP J M,ZACHARIS FJ.Benefits and potential harm of lowering high bloodpressure[J].Lancet,1987,581-584.
[19] ROMAN G C,TATEMICHI T,ERKINIJUTTI T,et al.Vascular dementia:diagnostic criteria for research studies.Report of the NINDSD-AIREN International Workshop[J].Neurology,1993,43:250-260.
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