预防痴呆,应优选ARB!中山大学孙逸仙纪念医院研究

2022-07-01 中国循环杂志 网络

应用 ARB 的患者中,CDR-SB、ADAS-Cog-13评分增长速度较慢。

既往的研究发现,在高血压患者中,肾素-血管紧张素系统(RAS)抑制剂可能有防止轻度认知功能受损向痴呆症进展的作用。

6月29日,中山大学孙逸仙纪念医院唐亚梅等在 Hypertension 杂志发表的一项回顾性队列研究进一步发现,在合并轻度认知功能受损的高血压患者中,血管紧张素 Ⅱ 受体拮抗剂(ARB)在预防痴呆症方面,优于血管紧张素转换酶抑制剂(ACEI)和其他类型的降压药物。

研究者认为,该研究结果可能对临床实践有重要启示意义,但仍需开展更大规模前瞻性队列研究或临床研究来验证。

该研究纳入 403 例基线有轻度认知功能受损的高血压患者,其平均年龄为 74 岁,37.7% 为女士。

中位随访 3 年期间,39.2% 的患者进展为痴呆症,3 年无进展生存率为 67%。

与不用降压药的患者相比,应用降压药物的患者 3 年无进展生存率明显升高(71% vs 41.6%)。其中,应用 RAS 抑制剂、其他降压药的患者中无进展生存率分别为 73.8% 和 65.8%。而应用 ARB 的患者中,3年无进展生存率明显高于应用 ACEI 的患者(80.9% vs 67.1%)。

多因素分析显示,与应用 ACEI、其他类型降压药(包括β受体阻滞剂、钙拮抗剂、利尿剂)、不用降压药的患者相比,应用 ARB 的患者进展为痴呆症的风险分别降低 55%、51%、69%。

进一步分析显示,应用 ARB 的患者中,CDR-SB、ADAS-Cog-13 评分增长速度较慢,而 Rey 听觉语言学习测试和 MMSE 评分下降速度也较慢,这进一步说明,ARB 有神经保护作用。

在该研究中,应用 ARB、ACEI、其他类型降压药、不用降压药的患者分别占 17.9%、35.0%、29.5%、14.4%。

来源:Angiotensin Receptor Blockers Are Associated With a Lower Risk of Progression From Mild Cognitive Impairment to Dementia. Hypertension, 29 Jun 2022

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    2022-07-23 屋顶瞄爱赏月

    签到学习

    0

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    2022-07-04 叶子12

    学习了

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1820173, encodeId=a40a18201e3ff, content=<a href='/topic/show?id=97011003512e' target=_blank style='color:#2F92EE;'>#预防痴呆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100351, encryptionId=97011003512e, topicName=预防痴呆)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sat Apr 01 14:30:06 CST 2023, time=2023-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1234268, encodeId=1402123426832, content=签到学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Sat Jul 23 16:40:37 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230397, encodeId=13b2123039ee1, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/12/539233de2bda9b8c67d179a9bf6036a1.jpg, createdBy=d4a42010049, createdName=叶子12, createdTime=Mon Jul 04 07:54:20 CST 2022, time=2022-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555789, encodeId=0cbb1555e891a, content=<a href='/topic/show?id=5900221140f' target=_blank style='color:#2F92EE;'>#中山大学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22114, encryptionId=5900221140f, topicName=中山大学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d5414663053, createdName=kalseyzl, createdTime=Sun Jul 03 00:30:06 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1247131, encodeId=eaad124e1314e, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Fri Jul 01 12:30:06 CST 2022, time=2022-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1229890, encodeId=3a2c122989045, content=应用 ARB 的患者中,CDR-SB、ADAS-Cog-13 评分增长速度较慢!<a href='/topic/show?id=1c1710265113' target=_blank style='color:#2F92EE;'>#高血压#</a><a href='/topic/show?id=18b3e120514' target=_blank style='color:#2F92EE;'>#痴呆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102651, encryptionId=1c1710265113, topicName=高血压), TopicDto(id=71205, encryptionId=18b3e120514, topicName=痴呆)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Fri Jul 01 10:22:22 CST 2022, time=2022-07-01, status=1, ipAttribution=)]
    2022-07-01 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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    2022-07-01 病毒猎手

    应用 ARB 的患者中,CDR-SB、ADAS-Cog-13 评分增长速度较慢!#高血压##痴呆#

    0

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