The Relationship Between Blood Pressure And The Elderly Cognitive Impairment

Objective:To investigate the relationship between blood pressure and the elderly cognitive impairment.Methods:930 cases older than 60 years were enrolled in this study. All the patients were chosen form neurological department of Fe icheng Mining Center Hospital.363 cases of male and 567 cases of female took blood pressure and cognitive function assessment (Minimum Mental State Examination, MMSE). Complete inform ation about gender, age, education level, whether or not taking an tihypertensive drugs, duration of hypertension, and chronic diseas e were also recorded. Of whom,120 hypertensive inpatients took a 24-hour ambulatory blood pressure monitoring. Then, the rela tionship between the demographic characteristics of the study (ge nder, age, marital status, education level, occupation) and MMSE s cores were analysised. In hypertensive group, the relationship bet ween blood pressure in different grade levels, pulse pressure lev el, duration of hypertension, antihypertensive therapy and cogniti ve function were determined. The relationship between the indica tors of 24-hour ambulatory blood pressure level and MMSE scor es were studied. The patients were enrolled according to striate d inclusion criteria and exclusion criteria. The data was analyze d and compared using the single factor analysis of variance (AN OVA) or t test and multiple linear regressions.Results:1. MMSE scores of normal blood pressure group and hypertensive group were (26.3±3.6) vs. (25.7±4.2). The differences were statistically significant (t=3.93, P<0.01). Women showed lower MMSE score than men. The death of a spouse or solitary had lower MMSE score than married people. MMSE score was gradually reduced with age, especially inpatients older than 85 years. The MMSE score was significantly associated with the level of education. MMSE score of manual worker is lower than the knowledge workers.2. MMSE score was gradually reduced with the increasing of blood pressure. There were significant differences indifferent diastolic pressure group (F=3.57, P<0.01) MMSE score was decreased with diastolic pressure. And so did in systolic blood pressure groups (F= 12.01, P<0.01). The impact of systolic blood pressure was more obvious than diastolic pressure.3. MMSE score was decreased with the increase of PP values. But there were no statistically significant differences between groups. In PP values between 40-69 mmHg, the differences between the groups were not statistically significant (P< 0.05).4. MMSE score was higher in hypertensive patients taking oral antihypertensive drugs than that of not taking antihypertensive medications.5.24 h ambulatory blood pressure level was closely associated with cognitive impairment, after controlled variables like age, gender, education level(P<0.05). MMSE score was negatively related to all blood pressure index, except for the diastolic blood pressure load values.Conclusions:The results suggest that there was significant correlation ship between blood pressure level and cognitive impairment. Cognitive function in patients with hypertension was significantly impaired than that in people with normal blood pressure. Cognitive function was decreased with the increase of blood pressure level. The impact of systolic blood pressure was more obvious than diastolic pressure.24 h ambulatory blood pressure level is closely associated with cognitive impairment. Therefore, it is benefit to take corresponding and effective intervention to hypertensive patients, especially smooth step-down, to prevent cognitive impairment and reduce the risk of cognitive impairment in the elderly.