The Impact Of Blood Pressure Rhythm On Vascular Cognitive Impariment

Purpose:To compare the circadian rhythm of blood pressure monitoring, theMoCA and MMSE scale assessment, in order to investigate the impact of24-hour blood pressure rhythm on vascular cognitive impariment.Methods:The study enrolled within a hospital neurological department fromJune2013to December2013outpatient and inpatient and90cases ofvascular cognitive cognitive disorders after screening scale, groupedaccording to the presence or absence of hypertension divided into purevascular cognitive dysfunction group (VCI alone group) and vascularcognitive impairment and hypertension group (VCI+HBP group)underwent24-hour ambulatory blood pressure monitoring, MoCA scale ofassessment, based on the detection the results VCI+HBP group is furtherdivided into dippers, non-dippers, ultra-dipper, anti-dipper four groups,each group further overall awareness and cognitive domains were analyzed,and then the blood pressure index and impaired cognitive domains Multiplelinear regression analysis.Results:The statistics of two groups which in age, sex, years of education were aged64.4±8.55years,63.9±9.08years; gender (male) were18(60%),34(57%); education (years) was10.5±3.6years,11.1±4.2years; diabetes(people) were15(50%),26(43%); dyslipidemia (people) were12(40%),26(43%); history of smoking (people) were13(43%)28(48%). History ofdrinking (people) were5(17%),12(20%); history of thyroid disease(people) were3(10%),2(3%); history of heart disease (people) were12(40%),26(43%),they were comparable. The blood pressure variation ratecomparison and analysis of the two groups were the dippers type7(20%),5(9.09%) X20.02, P0.062, the anti-dipper type12(40%),6(10%), X20.074, P0.786, the ultra-dipper type1(2.86%),7(11.17%), X20.494, P0.482,the non dipper type10(33.33%),42(70%), X20.39, P0.032, thevariation rate of blood pressure were8.91±2.54,7.89±1.79, X20.472, P0.041. The different rhythm type blood pressure set of MoCA score andcompare the cognitive domain, groups of MoCA scores, EF (function),MEM (memory), ATT (note) are statistically significant differences (P <0.05): EF (4.80±0.41,3.27±1.05,3.63±0.93,4.30±0.37). MEM(4.40±0.56,4.40±0.94,2.87±0.97,3.61±1.73). ATT (5.50±0.57,0.57±1.09,4.43±1.07,4.52±0.59). Each object of study of blood pressure indexto compare DSBP (daytime mean systolie blood pressure)121±3.21,148±4.56, t2.208, P <0.05; NSBP (nighttime mean systolie bloodpressure)108±4.12,120±3.25, t3.312, P <0.01). The two have statisticalsignificance. Blood pressure index on cognitive function of multiple regression analysis and correlation coefficient of executive function,respectively (DSBP-0.258, DDBP-0.594, NSBP-0.930, NDBP-0.977,blood pressure variation rate2.455), the correlation coefficient of delayedrecall, respectively (DSBP-0.160, DDBP-0.051, NSBP-0.062,NDBP-0.084, blood pressure variation rate0.139) to the attention of thecorrelation coefficient respectively (DSBP-1.273, DDBP-0.377,NSBP-0.484, NDBP-0.634, blood pressure variation rate0.282).Conclusions:(1) The changes in blood pressure rhythm obviously impacted on thecognitive function of patients with VCI, especially reflected in theexecutive function, and the impact of delayed recall attention, the non-dipper blood pressure rhythm was common.(2) The average systolic bloodpressure circadian obviously effected on the vascular cognitive function,especially executive function, delayed recall aspects of cognition, theimpact of delayed recall was more obvious,(3) The blood pressurevariation rate impacted the function obviously, the impact on executivefunction, delayed recall and attention were strongly correlations, thesmaller the rate of blood pressure variability was, the cognitive impairmentwas more obviously.