杜文雯, 贾小芳, 苏畅, 王志宏, 王惠君, 张丛笑, 朱辉萍, 杨勇, 张玉, 张兵. 中国四省55岁及以上人群血压状况与轻度认知障碍的关联[J]. 环境与职业医学, 2021, 38(8): 825-832. DOI: 10.13213/j.cnki.jeom.2021.20596
引用本文: 杜文雯, 贾小芳, 苏畅, 王志宏, 王惠君, 张丛笑, 朱辉萍, 杨勇, 张玉, 张兵. 中国四省55岁及以上人群血压状况与轻度认知障碍的关联[J]. 环境与职业医学, 2021, 38(8): 825-832. DOI: 10.13213/j.cnki.jeom.2021.20596
DU Wenwen, JIA Xiaofang, SU Chang, WANG Zhihong, WANG Huijun, ZHANG Congxiao, ZHU Huiping, YANG Yong, ZHANG Yu, ZHANG Bing. Association between hypertension and mild cognitive impairment among people aged 55 years and above in four provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 825-832. DOI: 10.13213/j.cnki.jeom.2021.20596
Citation: DU Wenwen, JIA Xiaofang, SU Chang, WANG Zhihong, WANG Huijun, ZHANG Congxiao, ZHU Huiping, YANG Yong, ZHANG Yu, ZHANG Bing. Association between hypertension and mild cognitive impairment among people aged 55 years and above in four provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 825-832. DOI: 10.13213/j.cnki.jeom.2021.20596

中国四省55岁及以上人群血压状况与轻度认知障碍的关联

Association between hypertension and mild cognitive impairment among people aged 55 years and above in four provinces of China

  • 摘要: 背景

    55岁及以上人群是高血压和认知功能障碍的高发群体。国外研究显示血压状况与认知功能下降有关,但我国相关领域的研究较少。

    目的

    了解我国四省55岁及以上人群血压状况及轻度认知障碍的人群分布特征,分析不同血压状况与轻度认知障碍的关系。

    方法

    研究资料来源于“神经系统疾病专病社区队列研究”2018—2019年基线调查数据。选取现场血压测量值、高血压诊断史、认知功能评估和个人基础信息等数据完整的55岁及以上人群作为研究对象,共4 452人。依据现场血压测量数据及是否有高血压诊断史,将血压状况分为以下四个类别:非高血压、高血压知晓(包括高血压控制、高血压未控制)和高血压不知晓。采用蒙特利尔认知评估量表进行总体认知功能评估,结合教育水平判定是否为轻度认知障碍。利用卡方检验比较不同特征分层的血压状况及轻度认知障碍的分布差异。采用多因素logistic回归模型分析不同血压状况与轻度认知障碍的关联。

    结果

    调查人群中总体高血压率为55.3%,其中高血压控制、高血压未控制和高血压不知晓的比例分别为11.8%、20.1%和23.4%。高血压患病率在城乡、年龄组、最高受教育水平、家庭人均月收入、工作状况、吸烟及BMI水平分组下差异均有统计学意义(P < 0.05)。轻度认知障碍检出率为38.1%。轻度认知障碍检出率在城乡、年龄组、最高受教育水平、家庭人均月收入及工作状况分组差异均有统计学意义(P < 0.05)。在控制了人口学因素、生活方式因素、膳食因素、BMI分级、居住地区后,多因素logistic回归分析显示,高血压不知晓组的轻度认知障碍风险为非高血压组的1.28(95%CI:1.06~1.55)倍。

    结论

    我国55岁及以上人群中高血压和轻度认知障碍问题突出。高血压不知晓与轻度认知障碍检出风险增加相关。

     

    Abstract: Background

    People aged 55 years and over is a high risk group of hypertension and mild cognitive impairment. Blood pressure is related to cognitive decline as reported by foreign research, while there are few studies in China.

    Objective

    This study is conducted to investigate the distribution characteristics of blood pressure status and mild cognitive impairment among people aged 55 years and over in four provinces of China, as well as to analyze the relationship between blood pressure status and mild cognitive impairment.

    Methods

    The research data were obtained from the baseline survey of "Community-based Cohort Study on Nervous System Diseases" from 2018 to 2019. A total of 4 452 individuals aged 55 years and over with complete data of blood pressure measurement, hypertension diagnosis history, cognitive function assessment, and demographic information were selected. According to the blood pressure measurement data and the history of hypertension diagnosis, blood pressure was divided into four categories: non-hypertension, diagnosed hypertension (including controlled hypertension and uncontrolled hypertension), and undiagnosed hypertension. The Montreal Cognitive Assessment was used to evaluate the overall cognitive function of the participants, and to identify mild cognitive impairment combining with educational level. Chi-square test was used to compare the distribution of blood pressure status and mild cognitive impairment among subgroups by selected characteristics. A multiple logistic regression model was used to analyze the association between blood pressure status and mild cognitive impairment.

    Results

    The prevalence rate of hypertension in the selected residents was 55.3%, among which the prevalence rates of controlled hypertension, uncontrolled hypertension, and undiagnosed hypertension were 1.8%, 20.1%, and 23.4%, respectively. Significant differences were found in the rate of hypertension among the people grouped by residence, age group, highest education level, household monthly income per capita, employment, smoking, and BMI level (P < 0.05). The positive rate of mild cognitive impairment was 38.1%. Significant differences were found in the positive rate of mild cognitive impairment among the people grouped by residence, age group, highest education level, household monthly income per capita, and employment (P < 0.05). After controlling for the variables of demographic factors, lifestyle, dietary factors, graded body mass index, and residence, the results of multiple logistic regression analysis indicated that the risk of mild cognitive impairment for the undiagnosed hypertension group was 1.28 (95% CI: 1.06-1.55) times higher than that for the non-hypertension group.

    Conclusion

    In China, hypertension and mild cognitive impairment are prominent in people aged 55 years and over. Undiagnosed hypertension is associated with an increased risk of mild cognitive impairment.

     

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