晚年血压与脑淀粉样血管病:美国国家阿尔茨海默氏症协调中心统一数据集的研究结果。

IF 3.2 Q2 CLINICAL NEUROLOGY
Mo-Kyung Sin, N Maritza Dowling, Jeffrey M Roseman, Ali Ahmed, Edward Zamrini
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引用次数: 0

摘要

高血压(BP)和脑淀粉样血管病(CAA)是颅内出血的两个常见危险因素,可能导致认知障碍。人们对血压与 CAA 之间的关系知之甚少,本研究的目的就在于研究两者之间的关系。我们分析了美国国家阿尔茨海默氏症协调中心(NACC)2510 名参与者的数据,这些参与者拥有生前的纵向血压测量数据和尸检的 CAA 数据。根据死前四次收缩压(SBP)的平均值,SBP 被分为三组:n = 435)、120-139 mmHg(n = 1335)和≥140 mmHg(n = 740)。1580 名参与者的 CAA 是通过免疫组化诊断出来的,分为轻度(n = 759)、中度(n = 529)和重度(n = 292)。在对死亡时的年龄、性别、APOE 基因型、Braak、CERAD、降压药物使用和微梗死进行调整后,与 SBP 为 120-139 mmHg 和 ≥140 mmHg 相关的 CAA 的几率比(95% CIs)分别为 0.91(0.74-1.12)和 1.00(0.80-1.26)。预测效应图显示,三个 SBP 类别之间发生 CAA 的概率没有差异。微出血与 CAA 无关,但在 SBP≥130 mmHg 的人群中,微出血的比例在数值上高于更严重的 CAA(趋势 p,0.084)。总之,我们没有发现 SBP 与 CAA 相关的证据。未来的研究需要开发诊断 CAA 的无创实验室检测方法,并对这种关联及其对阿尔茨海默病的病理生理学和预后的影响进行前瞻性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Late-Life Blood Pressure and Cerebral Amyloid Angiopathy: Findings from the U.S. National Alzheimer's Coordinating Center Uniform Dataset.

High blood pressure (BP) and cerebral amyloid angiopathy (CAA) are two common risk factors for intracranial hemorrhage, potentially leading to cognitive impairment. Less is known about the relationship between BP and CAA, the examination of which was the objective of this study. We analyzed data from 2510 participants in the National Alzheimer's Coordinating Center (NACC) who had information on longitudinal BP measurements before death and on CAA from autopsy. Using the average of four systolic BPs (SBPs) prior to death, SBP was categorized into three groups: <120 mmHg (n = 435), 120-139 mmHg (n = 1335), and ≥140 mmHg (n = 740). CAA was diagnosed using immunohistochemistry in 1580 participants and categorized as mild (n = 759), moderate (n = 529), or severe (n = 292). When adjusted for age at death, sex, APOE genotype, Braak, CERAD, antihypertensive medication use, and microinfarcts, the odds ratios (95% CIs) for CAA associated with SBPs of 120-139 and ≥140 mmHg were 0.91 (0.74-1.12) and 1.00 (0.80-1.26), respectively. Findings from predictor effect plots show no variation in the probability of CAA between the three SBP categories. Microbleeds had no association with CAA, but among those with SBP ≥ 130 mmHg, the proportion of those with microbleeds was numerically greater in those with more severe CAA (p for trend, 0.084). In conclusion, we found no evidence of an association between SBP and CAA. Future studies need to develop non-invasive laboratory tests to diagnose CAA and prospectively examine this association and its implication on the pathophysiology and outcome of Alzheimer's disease.

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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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