Investigation And Intervention Study On Blood Pressure And Blood Lipids In Patients With Post-stroke Cognitive Impairment In Community

Objective:To investigate the blood pressure and blood lipids of patients with post-stroke cognitive impairment in the community,and to discuss whether active intervention of blood pressure and blood lipids can improve the level of cognitive impairment.Methods:Select patients from two nonadjacent communities in Haikou City in Hainan Province who were diagnosed with stroke and had cognitive impairment from April 1st,2018 to March 31st,2019 as the research subjects.Establish disease health files,screen patients who meet the standard of the enrollment group and record their personal data,living habits,blood pressure,blood lipids and blood glucose,and use the Mini-mental state of examination(MMSE)and the Montreal Cognitive Assessment(MoCA)to assess the cognitive function of the enrolled patients.One of the communities was randomly selected to carry out active comprehensive intervention for secondary prevention of stroke on the enrolled patients,and the other community as the control group was only followed up.Correlation analysis of risk factors affecting cognitive function after stroke was performed,and multivariate regression analysis was conducted on the influencing factors of P<0.05 among the single factors affecting cognitive function score.Results:A total of 124 cases met the selection criteria in the two communities.Due to 37 of them with incomplete information(missing test results),15 of them didn’t cooperatate to complete the scale survy,finally,72 of them were included in the file,33 of them were in the control group,and 39 of them were in the intervention group.Among them,37 were male(51.4%),with an average age of68.14(±8.23)years,86.1%with less than 12 years of education,86.11%of patients had a higher systolic blood pressure(SBP)than normal(>140 mmHg,and 84.72%had higher diastolic blood pressure(DBP)than normal(>80mmHg),the low-density lipoprotein(LDL)is more than 1.80mmol/L in 79.17%of patients,and glycated hemoglobin(HbA1c)does not meet the standard(>6.5g/L),accounting for 25%of the total.Among the risk factors that affect cognitive function after stroke,age,SBP,DBP,LDL are correlated with MMSE scores(P=0.005,P=0.000,P=0.000,P=0.000),and they are also correlated with MoCA scores(P=0.000,P=0.000,P=0.000,P=0.001).HbA1c was not significantly correlated with MMSE and MoCA scores(P=0.230,P=0.837).The educational attainment,gender,smoking,drinking,less exercise were not statistically significant to cognitive decline(P>0.05).In multivariate linear regression analysis,there was an independent correlation between age,SBP,LDL and MoCA score(P=0.000,P=0.000,P=0.027),and there was an independent correlation between age,SBP,LDL and MMSE scores(P=0.024,P=0.000,P=0.001).There was no clear independent correlation between DBP,MoCA and MMSE scores(P=0.944,P=0.359).After 10 months,there was a statistically significant difference between the changes in computing ability scores of the two groups of patients(P=0.008),but there was no statistically significant difference in the MMSE changes between the two groups of patients(P=0.131).Conclusion:Active blood pressure and blood lipid intervention can play an active role in delaying the decline of computing ability,but simple risk factor intervention can not improve the overall cognitive function.The prevention and treatment of post-stroke cognitive impairment need more intervention methods,such as rehabilitation training of cognitive function and related drug treatment,etc.