我国中老年人累积血压与认知功能下降的关系

Association between cumulative blood pressure and cognitive function decline in middle-aged and elderly people in China

目的 探讨我国中老年人累积血压与认知功能下降发生风险的关系。方法 数据来源于2011—2018年的中国健康与养老追踪调查基线无认知障碍相关疾病的人群,累积血压采用曲线下面积对基线和随访(2011—2015年)的测量值进行估算,指标包括累积收缩压(cumSBP)和累积舒张压(cumDBP)。cumSBP(单位为mmHg·年)分组:低水平组(<360),正常水平组(360~<480),较高水平组(480~<560),高水平组(≥560)。cumDBP(单位为mmHg·年)分组:低水平组(<240),正常水平组(240~<320),较高水平组(320~<360),高水平组(≥360)。按照中文版简易智力状态检查测试量表(MMSE)对2018年认知功能结局进行评价,将参与者分为认知功能下降组和认知正常组,再使用多因素logistic回归模型分析累积血压与认知功能下降发生风险之间的关联。结果 研究共纳入10 366人中,其中男性4 715人,占45.5%,女性5 651人,占54.5%。至2018年,认知功能下降的患病人数为4 831,患病率为46.6%。多因素logistic回归分析显示,在校正混杂因素后,与累积水平正常组相比,cumSBP最高水平组的认知功能下降发生风险升高,OR(95%CI)为1.298(1.134~1.486)。随着cumSBP升高,认知功能下降的发生风险也随之增加。cumDBP与认知功能下降风险增加无关。结论 cumSBP是认知功能下降的危险因素,cumDBP与认知功能下降发生风险无关。

Objective To explore the relationship between cumulative blood pressure and the risk of cognitive function decline in middle-aged and elderly individuals in China.Methods The data were derived from the baseline of the China Health and Retirement Longitudinal Study from 2011 to 2018,focusing on individuals without cognitive impairment-related diseases.Cumulative blood pressure was estimated using the area under the curve for measurements taken at baseline and during follow-up(2011-2015).The indicators included cumulative systolic blood pressure(cumSBP) and cumulative diastolic blood pressure(cumDBP).CumSBP(mmHg·years) was stratified based on the following criteria:low level(<360);normal level(360-<480);higher level(480-<560);highest level(≥560).CumDBP(mmHg·years) was stratified based on the following criteria:low level,<240;normal level(240-<320);higher level(320-<360);highest level(≥360).The cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination(MMSE) in 2018.Participants were divided into cognitive decline and normal cognitive groups.Multiple logistic regression model was used to analyze the association between cumulative blood pressure and cognitive function decline.Results A total of 10 366 participants were included in the study.Among them,4 715 were male,accounting for 45.5%,and 5 651 were female,accounting for 54.5%.By 2018,the number of individuals with cognitive decline was 4 831,with a prevalence rate of 46.6%.After adjusting for confounding factors,compared to the group with normal cumSBP,the group with the highest cumSBP level exhibited a significantly increased risk of cognitive decline,with an OR of 1.298(95%CI 1.134-1.486).With the increase in cumSBP,the risk of cognitive decline also increased.CumDBP was not assoicated with cognitive function decline.Conclusion CumSBP is a risk factor for cognitive decline,while cumDBP is not associated with cognitive decline.