高血压与认知功能障碍

Hypertension and cognitive impairment

高血压与认知功能障碍的关系日益受到关注。中年期高血压可以增加老年期认知功能障碍的风险,而老年期血压水平与认知功能障碍的关系尚不明确。脉压差、血压变异率、血压昼夜节律等均与认知功能障碍有关。高血压可以影响脑血管结构和功能,引起脑卒中、脑白质病变、微梗死和微出血,从而导致认知功能障碍;还可以影响β-淀粉样蛋白的代谢和转运,诱发认知功能障碍。针对高血压患者特征的个体化治疗,可能是预防和治疗认知功能障碍的合理选择。

As a leading risk factor for stroke, hypertension is also an important risk factor forcognitive impairment. Midlife hypertension doubles the risk of dementia later in life and accelerates theprogression of dementia, but the correlation between late-life blood pressure and cognitive impairment isstill unclear. Beside blood pressure, the effect of pulse pressure, blood pressure variability and circadianrhythm of blood pressure on cognition is currently attracting more and more attention. Hypertensioninduces alterations in cerebrovascular structure and functions, which lead to brain lesions including cerebralatrophy, stroke, lacunar infarcts, diffuse white matter damage, microinfarct and microhemorrhage, resuling incognitive impairment. Hypertension also impairs the metabolism and transfer of amyloid-β protein（Aβ）,thus accelerates cognitive impairment. Individualized therapy, focusing on characteristics of hypertensivepatients, may be a good choice for prevention and treatment of cognitive impairment.