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中年高血压更易痴呆！我国学者Hypertension杂志221万余人分析

2020-06-05 朱朱 中国循环杂志

中年高血压
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近日，复旦大学附属华山医院和青岛市市立医院研究人员在Hypertension杂志联合发表的一项Meta分析提示，与老年时发生高血压者相比，中年发生高血压者更易出现认知功能障碍。

近日，复旦大学附属华山医院和青岛市市立医院研究人员在Hypertension杂志联合发表的一项Meta分析提示，与老年时发生高血压者相比，中年发生高血压者更易出现认知功能障碍。
 
当然，老年人如果收缩压较高、舒张压较低或血压波动大，痴呆风险也明显增加。
 
分析显示，在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。
 
另外，收缩压升高、舒张压升高、舒张压波动大的中年人出现痴呆症的风险分别增加54%、50%和65%。
 
针对5项相关研究的剂量反应分析显示，中年时收缩压>130 mmHg者，认知功能受损和痴呆症的发生风险将增加34%
 
老年时发生高血压与痴呆症、老年痴呆症风险之间无明显关联。
 
研究者发现，舒张压与老年痴呆症风险之间呈U型曲线关系。舒张压处于90~100 mmHg时，老年痴呆症发生风险最低。
 
该分析带来的好消息是，应用降压药物可降低痴呆风险。在应用降压药的人中，痴呆症、老年痴呆症、血管性痴呆的发生风险分别降低21%、19%和62%。
 
应用利尿剂、噻嗪类利尿剂、钙拮抗剂、血管紧张素转换酶抑制剂的人中，老年痴呆症风险分别降低34%、30%、26%、22%。
 
证据表明，应用降压药物超过5年对认知功能有明显保护作用，可将痴呆症和老年痴呆症发生风险分别降低44%和43%。
 
即便在已经有轻度认知功能受损的患者中，降压药物仍可将痴呆症风险降低15%。
 
但是，研究者指出，预防认知功能障碍的降压药物最佳剂量、疗程和类型均需要进一步研究。
 
中国心血管病风险评估和管理指南指出，生活方式干预是预防成年人血压升高以及治疗成人轻度高血压的有效手段。
 
对于血压水平高于130/80 mmHg者，建议生活方式干预。一般高血压患者血压应控制在140/90 mmHg以下（如能耐受可控制在130/80 mmHg以下）。
 
这项Meta分析的研究者从Pubmed数据库搜集到209项相关研究，其中136项观察性研究被纳入分析，共覆盖221万余人。
 
来源：
[1]Blood Pressure and Risks of Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of 209 Prospective Studies. Hypertension, 26 May 2020
[2]中国心血管病风险评估和管理指南编写联合委员会. 中国心血管病风险评估和管理指南.中国循环杂志, 2019, 33: 4-28.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2070600, encodeId=186b20e060097, content=<a href='/topic/show?id=a13a54112f5' target=_blank style='color:#2F92EE;'>#我国学者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54112, encryptionId=a13a54112f5, topicName=我国学者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Tue Oct 06 08:24:30 CST 2020, time=2020-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728532, encodeId=68331e285323c, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 09 07:24:30 CST 2021, time=2021-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=884046, encodeId=4789884046ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Wed Sep 09 23:40:09 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039195, encodeId=f0dc2039195d8, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Apr 02 00:24:30 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=601708, encodeId=58db601e086b, content=<a href='/topic/show?id=bdb78016436' target=_blank style='color:#2F92EE;'>#老年性痴呆#</a>在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80164, encryptionId=bdb78016436, topicName=老年性痴呆)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jun 07 10:27:22 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501477, encodeId=961d15014e7e5, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Sun Jun 07 05:24:30 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048625, encodeId=3f8a10486257d, content=老年人痴呆何药可用？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Fri Jun 05 17:24:30 CST 2020, time=2020-06-05, status=1, ipAttribution=)]
    2020-10-06 fusion

    #我国学者#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2070600, encodeId=186b20e060097, content=<a href='/topic/show?id=a13a54112f5' target=_blank style='color:#2F92EE;'>#我国学者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54112, encryptionId=a13a54112f5, topicName=我国学者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Tue Oct 06 08:24:30 CST 2020, time=2020-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728532, encodeId=68331e285323c, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 09 07:24:30 CST 2021, time=2021-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=884046, encodeId=4789884046ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Wed Sep 09 23:40:09 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039195, encodeId=f0dc2039195d8, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Apr 02 00:24:30 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=601708, encodeId=58db601e086b, content=<a href='/topic/show?id=bdb78016436' target=_blank style='color:#2F92EE;'>#老年性痴呆#</a>在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80164, encryptionId=bdb78016436, topicName=老年性痴呆)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jun 07 10:27:22 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501477, encodeId=961d15014e7e5, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Sun Jun 07 05:24:30 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048625, encodeId=3f8a10486257d, content=老年人痴呆何药可用？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Fri Jun 05 17:24:30 CST 2020, time=2020-06-05, status=1, ipAttribution=)]
    2021-02-09 feather89

    #PE#

    0

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    2020-09-09 12177770m58暂无昵称

    学习了

    0

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    2021-04-02 12498ebem19暂无昵称

    #TENS#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2070600, encodeId=186b20e060097, content=<a href='/topic/show?id=a13a54112f5' target=_blank style='color:#2F92EE;'>#我国学者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54112, encryptionId=a13a54112f5, topicName=我国学者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Tue Oct 06 08:24:30 CST 2020, time=2020-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728532, encodeId=68331e285323c, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 09 07:24:30 CST 2021, time=2021-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=884046, encodeId=4789884046ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Wed Sep 09 23:40:09 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039195, encodeId=f0dc2039195d8, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Apr 02 00:24:30 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=601708, encodeId=58db601e086b, content=<a href='/topic/show?id=bdb78016436' target=_blank style='color:#2F92EE;'>#老年性痴呆#</a>在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80164, encryptionId=bdb78016436, topicName=老年性痴呆)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jun 07 10:27:22 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501477, encodeId=961d15014e7e5, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Sun Jun 07 05:24:30 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048625, encodeId=3f8a10486257d, content=老年人痴呆何药可用？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Fri Jun 05 17:24:30 CST 2020, time=2020-06-05, status=1, ipAttribution=)]
    2020-06-07 lovetcm

    #老年性痴呆#在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2070600, encodeId=186b20e060097, content=<a href='/topic/show?id=a13a54112f5' target=_blank style='color:#2F92EE;'>#我国学者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54112, encryptionId=a13a54112f5, topicName=我国学者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Tue Oct 06 08:24:30 CST 2020, time=2020-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728532, encodeId=68331e285323c, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 09 07:24:30 CST 2021, time=2021-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=884046, encodeId=4789884046ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Wed Sep 09 23:40:09 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039195, encodeId=f0dc2039195d8, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Apr 02 00:24:30 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=601708, encodeId=58db601e086b, content=<a href='/topic/show?id=bdb78016436' target=_blank style='color:#2F92EE;'>#老年性痴呆#</a>在中年发生高血压者中，认知功能障碍风险增加了55%，执行功能障碍风险增加22%，痴呆症发生风险增加20%，老年痴呆症（阿尔茨海默病）发生风险增加19%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80164, encryptionId=bdb78016436, topicName=老年性痴呆)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jun 07 10:27:22 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501477, encodeId=961d15014e7e5, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Sun Jun 07 05:24:30 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048625, encodeId=3f8a10486257d, content=老年人痴呆何药可用？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Fri Jun 05 17:24:30 CST 2020, time=2020-06-05, status=1, ipAttribution=)]
    2020-06-07 jambiya

    #Hypertension#

    0

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    2020-06-05 junJUN

    老年人痴呆何药可用？？

    0