J Gen Intern Med:Wow!控制血压还能预防痴呆

2018-11-25 吴星 环球医学

2018年4月,美国学者在《J Gen Intern Med》发表了一项前瞻性队列研究,在非裔美国人中,评估了降压药和血压对痴呆发作的纵向影响。

2018年4月,美国学者在《J Gen Intern Med》发表了一项前瞻性队列研究,在非裔美国人中,评估了降压药和血压对痴呆发作的纵向影响。

背景:非裔美国人尤其处于高血压和痴呆风险之中。降压药可降低血管事件风险,可能也会降低痴呆风险。

目的:在一个非裔美国人队列中,评估降压药和血压对痴呆发作的纵向影响。

设计:前瞻性队列。

参与者:来自于公共卫生保健系统的1236名社区居住的患者,年龄≥65岁,有高血压史但无痴呆病史,有至少3次初级机构就诊记录和至少1次任何药物处方史。

主要测量指标:血压取3次坐位测量的平均值。采用两阶段设计确诊痴呆,每2到3年进行一次筛查评估,随后对筛查为阳性的患者进行全面的家庭临床评估。从健康信息交换系统中获得实验室、住院患者和门诊患者的就诊数据、诊断和手术编码,以及用药记录。

关键结果:1236名基线时无痴呆的高血压患者中,114人(9%)在随访期内进展痴呆。与未治疗的高血压患者(420人)相比,处方任何降压药的患者(816人)痴呆风险显着降低(风险比[HR]=0.57;95% 置信区间[CI],0.37~0.88,p=0.0144)。当纳入一个表明血压治疗欠佳(收缩压>140 mmHg或舒张压>90 mm Hg)的变量后再次重复分析时,降压药的作用不再具有统计学显着性(HR=0.65;95% CI,0.32~1.30;p=0.2217)。

结论:血压控制是老年非裔美国高血压患者预防痴呆的关键干预措施,大多数常见的可及降压药具有相似的获益。

原始出处:

Murray MD, Hendrie HC, Lane KA, et al. Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study. J Gen Intern Med. 2018 Apr;33(4):455-462. doi: 10.1007/s11606-017-4281-x.

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    2018-11-27 hb2008ye
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    2018-11-25 junJUN

    老年人痴呆何药可用??

    0

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    2018-11-25 医者仁心5538

    加强宣传,加大力度严格控制

    0

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