高龄老人高血压病与认知功能减退有相关性

Hypertension and cognitive function impairment in very elderly subjects

目的:分析80岁以上高龄高血压病与认知功能减退的关系。方法:对210例高血压病患者和140例非高血压患者采用简易精神状况检查表(MMSE)进行认知功能检查,并收集相关资料。结果:高血压病患者的MMSE总分,定向力和视空间觉得分明显低于非高血压病组,差异有统计学意义(P<0.05)。随着病程延长,各亚组MMSE得分的均值出现下降趋势,高血压病程≥40年患者MMSE得分明显低于<40年患者(P<0.01)。降压达标者MMSE得分明显高于未达标者(P<0.05)。按不同的血压程度分组进行Logistic回归分析发现高收缩压(≥160mmHg)、高脉压(≥60 mmHg)是高龄老人高血压病患者认知功能减退的独立危险因素。结论:收缩压、脉压、高血压病程、降压是否达标与高龄高血压病患者认知功能减退有关。

AIM： To investigate the relationship between hypertension and cognitive function impairment in the very elderly. METHODS： General conditions and health status were surveyed in 210 individuals with hypertension and 140 controls. Patients＇ cognitive function was assessed by the mini-mental state examination （MMSE） and other relative data were collected. RESULTS： The scores of total MMSE, orientation and visuospatial perception in hypertensive subjects were lower than those in non-hypertensive subjects （P 〈 0.05）. MMSE score decreased with the increasing duration of hypertension. MMSE scores in patients with hypertension 〉~40 years were significantly lower than those in patients with hypertension who were no more than 40 years （P 〈 0. 01 ）. MMSE scores of patients who achieved target blood pressure were significantly higher than those who failed to achieve target blood pressure （P 〈 0. 05）. Logistic regression analysis in groups with different blood pressure level revealed that high diastolic pressure （ ~〉 160 mmHg） and high pulse pressure （ 360 mmHg） were independent risk factors for the impairment of cognitive function in the very elderly. CONCLUSION： Cognitive function impairment in the very elderly is closely associated with high diastolic pressure, high pulse pressure, longer duration of hypertension and failure to achieving target blood pressure. Prevention and control of hypertension may be helpful in slowing down impairment of cognitive function in very elderly subjects.