The Dosage Dependent Effect Of Valsartan On Cognitive Function In Postmenopausal Women With Hypertension

Objective:Hypertension is a cardiovascular syndrome characterized by continuous increase of arterial blood pressure.It is the main risk factor of cardiovascular and cerebrovascular disease and the main cause of death of cardiovascular and cerebrovascular disease in China.In recent years,an epidemiological survey of hypertension in China has found that the prevalence of hypertension is on the rise.Hypertension,as one of the main risk factors of cardiovascular disease,stroke and cognitive impairment,has attracted wide attention.As a special group of postmenopausal women,the incidence of hypertension and related organ damage?HMOD?such as coronary heart disease,heart failure,stroke and cognitive impairment has increased significantly.Estradiol has been shown to be a neuroprotective agent that can counteract the degeneration of nerve cells and delay the degree of cognitive decline in women and is particularly important for maintaining normal cognitive function.Estradiol also induces structural and functional changes in other nervous systems,including the striatum,amygdala and cortex.Therefore,it is urgent for postmenopausal women with hypertension to put forward a more reasonable antihypertensive program to prevent and delay the occurrence and development of cognitive dysfunction.This study investigated the effects of valsartan on cognitive function in postmenopausal women with hypertension in a dose-dependent manner.Methods:From January 1,2017 to September 30,2017,82 patients with essential hypertension were selected.All patients included in the study met the inclusion criteria.In the first3 months,4 patients withdrew from the study,10 patients had difficulty in controlling blood pressure,so they were not included in this study and continued to be treated in hypertension clinic.There were 34 postmenopausal hypertensive patients?mean age 56.55±7.12?in high dose valsartan?273mg±15.81mg?group,34 postmenopausal hypertension patients?80mg?group with single dose valsartan group?mean age 56.43±5.27?.At the same time,34 postmenopausal women of normal age without hypertension were selected in the physical examination center of our hospital,with an average age of 56.62±6.17.All patients were followed up for 1 year to observe the changes of their indexes.Age,sex,height,weight,systolic blood pressure?SBP?,diastolic blood pressure?DBP?,Progesterone?P?,luteinizing hormone?LH?,prolactin?PRL?,estradiol?E₂?,follicle stimulating hormone?FSH?and testosterone?T?were measured.Blood safety was monitored by blood routine and biochemical indexes.Left atrial diameter,left ventricular end-diastolic diameter,diastolic septal thickness,left ventricular posterior wall thickness and left ventricular mass index were measured by echocardiography.Blood vessel function:central arterial pressure,ankle brachial index,blood pressure changes before and after treatment were evaluated with ambulatory blood pressure,and MMSE,MoCA cognitive scale was filled out before and after treatment.All the above data were statistically analyzed by SPSS22.0 software.The normal distribution data were expressed by mean±standard deviation.The data of non-normal distribution were converted to normal distribution first and then analyzed statistically,and the data of non-normal distribution were transformed into normal distribution and then analyzed statistically,and the data of normal distribution were expressed as mean±standard deviation.The difference was statistically significant?P<0.05?.Results:Before and after treatment,there was no significant difference in age,height,weight,BMI,blood routine and biochemical indexes between the three groups?P>0.05?.After treatment,the orientation,attention and computational power of MMSE cognitive scale,orientation of MoCA cognitive scale,abstraction,delayed recall,visual space and executive ability were significantly improved?P<0.05?.The language ability of postmenopausal women with single dose valsartan was improved by MMSE cognitive scale?P<0.05?compared with that before treatment?P<0.05?.In the measurement of central arterial pressure,cfPWV was significantly improved after treatment with different doses of valsartan?P<0.05?.In addition,the results showed that there were significant differences in Alx and Alx75HR in postmenopausal women with hypertension after treatment with large doses of valsartan?P<0.05?.In terms of sex hormones,there were significant differences in P,E₂ and low-dose valsartan in postmenopausal women with hypertension between the high-dose valsartan group and the low-dose valsartan group?P<0.05?.After treatment,the levels of these two hormones were higher than those of before.There were no significant differences in color doppler echocardiography,ambulatory blood pressure and ankle-brachial index between the two groups before and after treatment?P>0.05?.Conclusion:In postmenopausal women with hypertension,with different degrees of cognitive dysfunction,different doses of valsartan on postmenopausal female hypertension patients'cognitive function,sex hormones,arteriosclerosis and other aspects of the improvement degree is not consistent.The cognitive function of high-dose valsartan postmenopausal women with hypertension was significantly improved.