2025 年第 3 期 第 20 卷

高血压患者血压达标情况与认知水平的相关性分析

Correlation analysis between blood pressure control and cognitive level in patients with hypertension

作者：石继慧沈婷何柳马长生

英文作者：Shi Jihui Shen Ting He Liu Ma Changsheng

单位：首都医科大学附属北京安贞医院心内科国家心血管病临床医学研究中心，北京100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China

关键词：高血压；血压控制；认知障碍；认知域

英文关键词：Hypertension;Bloodpressurecontrol;Cognitiveimpairment;Cognitivedomain

• 摘要：

• 目的 探讨高血压患者血压控制达标情况与认知水平的关系。方法 选取2019年10月至2023年9月于首都医科大学附属北京安贞医院心内科就诊的7 718例高血压病患者。根据患者血压控制情况分为达标组和不达标组。分析比较2组患者认知功能状态［蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)评分］。校正混杂因素后，采用二元逻辑回归模型分析血压控制达标情况与认知评分的关系。结果 7 718例患者中血压控制不达标者5 618例（72.8%），血压控制达标者2 100例（27.2%）。校正混杂因素后，血压控制达标组MoCA评分中视空间与执行功能（比值比=1.09，95%置信区间：1.03～1.16，P=0.002）、注意力（比值比=1.05，95%置信区间：1.01～1.09，P=0.027）、语言（比值比=1.05，95%置信区间：1.01～1.09，P=0.010）、抽象能力（比值比=1.04，95%置信区间：1.01～1.08，P=0.022）、MoCA总分（比值比=1.25，95%置信区间：1.06～1.47，P=0.007），MMSE评分中回忆能力（比值比=1.05，95%置信区间：1.01～1.10，P=0.010）、语言能力（比值比=1.08，95%置信区间：1.04～1.11，P＜0.001）以及MMSE总分（比值比=1.19，95%置信区间：1.06～1.33，P=0.004）均高于不达标组。结论 高血压患者人群中，血压控制不达标的患者相比血压控制达标的患者认知功能下降。

• Objective  To explore the relationship between blood pressure control and cognitive level in patients with hypertension. Methods A total of 7 718 hypertensive patients admitted to the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University from October 2019 to September 2023 were selected. According to the blood pressure control, the patients were divided into standard group and non standardgroup. The cognitive function status ［Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores］ were analyzed and compared between the two groups. After adjusting for confounding factors, binary Logistic regression model was used to analyze the relationship between blood pressure control and cognitive scores. Results Among the 7 718 patients, 5 618(72.8%) patients had poor blood pressure control and 2 100(27.2%) patients had good blood pressure control. After adjusting for confounding factors, the scores of visuospatial and executive function［odds ratio(OR)=1.09, 95% confidence interval(CI): 1.03-1.16, P=0.002］, attention(OR=1.05, 95% CI: 1.01-1.09, P=0.027), language(OR=1.05, 95% CI: 1.01-1.09, P=0.010), abstract ability(OR=1.04, 95% CI: 1.01-1.08, P=0.022) and the total score of MoCA(OR=1.25, 95% CI: 1.06-1.47, P=0.007) in the standard group were higher than those in the non standardgroup. The scores of memory(OR=1.05, 95% CI: 1.01-1.10, P=0.010) and language ability(OR=1.08, 95% CI: 1.04-1.11, P<0.001) in MMSE and the total score of MMSE(OR=1.19, 95% CI: 1.06-1.33, P=0.004) in the standard group were higher than those in the non standardgroup. Conclusions  In patients with hypertension, patients with uncontrolled blood pressure have worse cognitive function than those with controlled blood pressure.