J Am Soc Nephrol:高血压强化治疗对肾功能、痴呆症和轻度认知障碍的影响

2021-04-18 MedSci原创 MedSci原创

既往研究表明,强化治疗高血压有益于患者的心血管疾病和认知功能,但短期内以肾功能下降为代价。近日,研究人员比较了强化(<120 mm Hg)与标准(<140 mm Hg)收缩压降低对患者痴呆

既往研究表明,强化治疗高血压有益于患者的血管疾病和认知功能,但短期内以肾功能下降为代价。近日,研究人员比较了强化(<120 mm Hg)与标准(<140 mm Hg)收缩压降低对患者痴呆症和轻度认知障碍(MCI)发生率的影响,研究结果已发表于J Am Soc Nephrol。

该项随机收缩压干预试验纳入了9361名参与者,根据eGFR和尿白蛋白与肌酐比值的基线和纵向变化对参与者进行分类。主要结果是发生判定可能的痴呆和MCI。

 

结果显示,在随访期间完成至少一次认知评估的8563名参与者中(中位数为5.1年),325名(3.8%)参与者可能进展为痴呆,640名(7.6%)参与者发生了MCI。多变量分析结果显示,基线eGFR<60 ml/min/1.73 m2与痴呆或MCI风险之间没有显著关联。时变分析结果显示,eGFR下降≥30%与痴呆发生的风险较高相关。eGFR<60 ml/min/1.73 m2与较高的MCI风险和痴呆或MCI的综合风险相关。虽然这些肾脏事件在强化治疗组中发生的频率更高,但没有证据表明它们改变或减弱了强化治疗对痴呆和MCI发生率的影响。基线和尿ACR≥30mg/g与痴呆或MCI无关,尿ACR也没有改变强化治疗对患者认知结果的影响。

综上所述,该研究结果表明,在高血压成年人中,以eGFR评估的肾功能下降与痴呆症和MCI风险增加有关,与高血压治疗的强度无关。

 

原始出处:

 

Manjula Kurella Tamura, et al., Kidney Disease, Intensive Hypertension Treatment, and Risk for Dementia and Mild Cognitive Impairment: The Systolic Blood Pressure Intervention Trial. J Am Soc Nephrol. 2020 Sep;31(9):2122-2132. doi: 10.1681/ASN.2020010038.  

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    2022-02-11 Boyinsh
  2. [GetPortalCommentsPageByObjectIdResponse(id=1836256, encodeId=8684183625698, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Fri Feb 11 09:01:57 CST 2022, time=2022-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850785, encodeId=301f1850e85be, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Tue Oct 26 02:01:57 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976535, encodeId=1eac9e6535e2, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a272265480, createdName=12192b1am98暂无昵称, createdTime=Thu Jun 24 15:18:37 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974813, encodeId=74649e4813a7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a272265480, createdName=12192b1am98暂无昵称, createdTime=Sat Jun 19 09:48:44 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554087, encodeId=a4cf155408eec, content=<a href='/topic/show?id=394d5013059' target=_blank style='color:#2F92EE;'>#强化治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50130, encryptionId=394d5013059, topicName=强化治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bcc714501479, createdName=huanbaofeng, createdTime=Tue Apr 20 13:01:57 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958367, encodeId=7a1f95836e9a, content=在高血压成年人中,以eGFR评估的肾功能下降与痴呆症和MCI风险增加有关,与高血压治疗的强度无关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b515466016, createdName=ms5000002050027133, createdTime=Mon Apr 19 14:02:39 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048767, encodeId=62131048e6709, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Mon Apr 19 01:01:57 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958105, encodeId=28b295810522, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Apr 18 22:20:53 CST 2021, time=2021-04-18, status=1, ipAttribution=)]
    2021-10-26 yese
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    2021-06-24 12192b1am98暂无昵称

    谢谢分享

    0

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    2021-06-19 12192b1am98暂无昵称

    学习了

    0

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    2021-04-19 ms5000002050027133

    在高血压成年人中,以eGFR评估的肾功能下降与痴呆症和MCI风险增加有关,与高血压治疗的强度无关。

    0

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    2021-04-19 junJUN

    老年人痴呆何药可用??

    0

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    2021-04-18 wxl882001

    了解

    0

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