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高血压患者认知功能障碍影响因素Meta分析

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目的 系统评价高血压患者发生认知功能障碍(CI)的影响因素.方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、Ovid、Scopus、EBSCO、CNKI、Wan Fang Data、VIP 和 CBM 数据库,检索时限均为建库至2023年3月,搜集有关高血压患者CI影响因素的研究.由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,使用RevMan 5.3和Stata 14.0软件进行Meta分析.结果 共纳入26篇文献,包括13 464名患者.Meta分析结果显示:降压药物的使用[OR=0.22,95%CI(0.09,0.59),P=0.002]、血压控制好[OR=0.48,95%CI(0.37,0.62),P<0.001]、社会支持[OR=0.94,95%CI(0.90,0.97),P<0.001]均是高血压患者发生CI 的保护因素;而年龄[OR=1.17,95%CI(1.12,1.22),P<0.001]、年龄≥60 岁[OR=2.10,95%CI(1.71,2.57),P<0.001]、女性[OR=1.55,95%CI(1.25,1.93),P<0.001]、单身[OR=2.39,95%CI(1.89,3.03),P<0.001]、吸烟[OR=3.40,95%CI(2.40,4.82),P<0.001]、文化程度(低于大专)[OR=3.46,95%CI(2.73,4.39),P<0.001]、受教育年限(≤ 12 年)[OR=2.10,95%CI(1.43,3.07),P<0.001]、糖尿病[OR=2.82,95%CI(2.22,3.58),P<0.001]、高脂血症[OR=1.48,95%CI(1.10,2.00),P=0.01]、总胆固醇[OR=1.11,95%CI(1.01,1.22),P=0.02]、CVHI 异常[OR=6.24,95%CI(3.75,10.37),P<0.001]、睡眠障碍[OR=2.92,95%CI(1.93,4.42),P<0.001]、收缩压[OR=1.04,95%CI(1.02,1.06),P<0.001]、直立性低血压[OR=1.39,95%CI(1.20,1.62),P<0.001]、高血压分级(2 级)[OR=2.62,95%CI(1.83,3.73),P<0.001]、高血压分级(3 级)[OR=3.15,95%CI(1.90,5.22),P<0.001]、应激史[OR=4.57,95%CI(2.86,7.30),P<0.001]均是发生CI的危险因素.结论 当前证据表明,高血压患者发生CI的影响因素较多,在今后对高血压患者发生CI的影响因素评估要更加全面.
Influencing factors of cognitive impairment in patients with hypertension:a meta-analysis
Objective To systematically review the factors for cognitive impairment in hypertensive patients.Methods PubMed,Web of Science,Embase,Cochrane Library,Ovid,Scopus,EBSCO,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023.Two reviewers independently screened literature,extracted data and evaluated the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software.Results A total of 26 articles involving 13 464 patients were included.The results of meta-analysis showed that antihypertensive drug use(OR=0.22,95%CI 0.09 to 0.59,P=0.002),blood pressure was well controlled(OR=0.48,95%CI 0.37 to 0.623,P<0.001),and social support(OR=0.94,95%CI 0.90 to 0.97,P<0.001)were protective factors for CI in hypertensive patients.And age(OR=1.17,95%CI 1.12 to 1.22,P<0.001),age ≥ 60(OR=2.10,95%CI 1.71 to 2.57,P<0.001),female(OR=1.55,95%CI 1.25 to 1.93,P<0.001),single(OR=2.39,95%CI 1.89 to 3.03,P<0.001),smoking(OR=3.40,95%CI 2.40 to 4.82,P<0.001),educational level(<college)(OR=3.46,95%CI 2.73 to 4.39,P<0.001),education years(≥ 12 years)(OR=2.10,95%CI 1.43 to 3.07,P<0.001),diabetes(OR=2.82,95%CI 2.22 to 3.58,P<0.001),hyperlipidemia(OR=1.48,95%CI 1.10 to 2.00,P=0.01),total cholesterol(OR=1.11,95%CI 1.01 to 1.22,P=0.02),CVHI anomalies(OR=6.24,95%CI 3.75 to 10.37,P<0.001),sleep disorder(OR=2.92,95%CI 1.93 to 4.42,P<0.001),systolic blood pressure(OR=1.04,95%CI 1.02 to 1.06,P<0.001),orthostatic hypotension(OR=1.39,95%CI 1.20 to 1.62,P<0.001,grade 2 hypertension(OR=2.62,95%CI 1.83 to 3.73,P<0.001),grade 3 hypertension(OR=3.15,95%CI 1.90 to 5.22,P<0.001),stress history(OR=4.57,95%CI 2.86 to 7.30,P<0.001)were all risk factors.Conclusion The current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients,and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more comprehensive in the future.

HypertensionCognitive impairmentInfluencing factorsMeta-analysis

赵子冉、阳晓丽、郭洪花、夏燕、李文、谭春苗、张彩虹

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海南医学院国际护理学院(海口 571199)

海南省托老院(海口 570100)

海南医学院第一附属医院老年科(海口 570102)

高血压 认知功能障碍 影响因素 Meta分析

海南省自然科学基金海南省自然科学基金海南省研究生创新科研项目

820RC779821RC560Qhys2022-309

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(5)
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