Peking University Research: Borderline hypertension is also exploring the borderline of cognitive decline?

In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) Adult Hypertension Guidelines (BP) proposed a new definition of hypertension, with a threshold BP level of 130/80 mmHg
.

However, the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guidelines adhere to the traditional definition of hypertension, that is, BP≥140/90 mmHg

prevention

Large-scale epidemiological studies have shown that middle-aged hypertension is significantly associated with an increase in the rate of cognitive decline in later life and a higher risk of dementia
.

Middle-aged hypertension, defined as BP≥140/90 mmHg, is associated with 1.

BP <130/80 mmHg in all cases throughout the study process; (2) Boundary BP group ( in the entire study process, BP <140/90 mmHg in all cases, except for the normal group)

The study finally included 17,590 participants with complete baseline data, BP measurement ≥ 3 times, and at least one reassessment of cognitive function
.

1.
BP group and cognitive decline

BP group and cognitive decline

Since there is considerable inter-cohort heterogeneity in the combined analysis of the overall cognitive decline in the normal group and the marginal BP group, the subsequent analysis was conducted by gender
.

After adjusting for covariates, no significant difference was found in the overall cognitive decline rate between the normal and marginal blood pressure groups (male, combined β = −0.

Since there is considerable inter-cohort heterogeneity in the combined analysis of the overall cognitive decline in the normal group and the marginal BP group, the subsequent analysis was conducted by gender

The overall cognitive decline of the hypertension group was significantly faster than that of the borderline blood pressure group (male, combined β =-0.

Compared with the normal blood pressure group, women in the hypertension group had a significantly faster decline in overall cognitive ability (combined β =-0.

2.
Sensitivity analysis

Sensitivity analysis

In any sensitivity analysis, it was not observed between the rate of cognitive decline of normal blood pressure group and the borderline significant difference (FIG.
2; Additional file 1: Table S5 to S8)
.

In any sensitivity analysis, it was not observed between the rate of cognitive decline of normal blood pressure group and the borderline significant difference (FIG.
2; not observed rate of cognitive decline between normal blood pressure group and the borderline significant difference additional File 1: Tables S5 to S8)
.

3.
Situation analysis

3.
Situation analysis

A total of 20,700 participants (HRS 7770; ELSA 6329; CHARLS 6601); during the entire study, blood pressure measurements less than 3 times or no subsequent cognitive scores were excluded (Figure 3)
.

Participants who were excluded showed the following characteristics in all three cohorts: older age, higher systolic blood pressure, lower education level, more likely to live alone, less physical activity, higher incidence of self-reported coronary heart disease, The execution score is low (Additional File 1: Table S9)

A total of 20,700 participants (HRS 7770; ELSA 6329; CHARLS 6601); during the entire study, blood pressure measurements less than 3 times or no subsequent cognitive scores were excluded (Figure 3)

In summary, in a pooled study of HRS, ELSA, and CHARLS with a large nationally representative sample, we observed that the cognitive decline of the high BP group was significantly faster than the adjusted boundary BP group, while the normal and boundary BP groups No significant difference in the rate of cognitive decline was found
.

These findings are valid in most single cognitive domains and sensitivity analyses

In summary, in a pooled study of HRS, ELSA, and CHARLS with a large nationally representative sample, we observed that the cognitive decline of the high BP group was significantly faster than the adjusted boundary BP group, while the normal and boundary BP groups No significant difference in the rate of cognitive decline was found
.
These findings are valid in most single cognitive domains and sensitivity analyses
.
Under the different hypertension thresholds of the ACC/AHA guidelines and the ESC/ESH guidelines, this study is the first and one of the largest studies to analyze the relationship between long-term blood pressure and the rate of cognitive decline
.
In summary, in a pooled study of HRS, ELSA, and CHARLS with a large nationally representative sample, we observed that the cognitive decline of the high BP group was significantly faster than the adjusted boundary BP group, while the normal and boundary BP groups No significant difference in the rate of cognitive decline was found
.
These findings are valid in most single cognitive domains and sensitivity analyses
.
Under the different hypertension thresholds of the ACC/AHA guidelines and the ESC/ESH guidelines, this study is the first and one of the largest studies to analyze the relationship between long-term blood pressure and the rate of cognitive decline
.
Under the different hypertension thresholds of the ACC/AHA guidelines and the ESC/ESH guidelines, this study is the first and one of the largest studies to analyze the relationship between long-term blood pressure and the rate of cognitive decline
.

In general, compared with the hypertension group, the cognitive decline of the borderline hypertension group was significantly slower, but there was no significant difference in the cognitive decline rate of the normal blood pressure group
.
The results of this study show that for patients with blood pressure between 130/80 and 140/90 mmHg, considering the decline in cognitive ability, it may not be necessary to start antihypertensive therapy ,prospective observation and interventional study of long-term blood pressure and cognition The relationship between decline in capacity is necessary
.

In general, in general,compared with the hypertension group, the cognitive decline of the borderline hypertension group was significantly slower, but there was no significant difference in the cognitive decline rate of the normal blood pressure group
.
The results of this study indicate that for patients with blood pressure between 130/80 and 140/90 mmHg, considering the decline in cognitive ability, it may not be necessary to start antihypertensive therapy .
For blood pressure between 130/80 and 140/90 mmHgAmongpatients, considering the decline in cognitive ability, it may not be necessary to start antihypertensive therapy.
Prospective observation and interventional studies on the relationship between long-term blood pressure and cognitive decline are necessary
.

 

Original source:

Ma et al.
Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts.
BMC Medicine (2021) 19:287
https://doi.
org/10.
1186/s12916-021-02165-4

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