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Prospective associations between pulse pressure and cognitive performance in Chinese middle-aged and older population across a 5-year study period

机译：5年学习期间中年人口中脉压和认知性能的预期联想

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Abstract Background Substantial evidence indicates that the relationship between blood pressure (BP) measures and cognitive functioning is inconsistent, complex, and age-related. Pulse pressure (PP), which can not only reflect arterial stiffness and but also represent the chronic effects of hypertension other than BP itself, has been considered as a better predictor of cognitive impairment. However, evidence on the association of cognitive function with PP has not been investigated extensively. We examined this relationship in a longitudinal study based on the latent growth model (LGM). Methods This study was based on a nationally representative sample of Chinese middle-aged and older participants from the China Health and Retirement Longitudinal Study (CHARLS), a prospective observational study conducted from 2011 to 2016. Cognitive performance was assessed on the basis of three measures of cognition. The PP was calculated as the difference of the average values of three systolic and diastolic BP readings. A series of potential confounders were collected in this research. The LGM was used to examine the effects of PP on cognitive performance at three time points. To test the independent effects of PP on the initial level and the subsequent development of cognition, unconditional and conditional models were compared sequentially. Results After excluding respondents with missing key variables, we ultimately included 9750 participants in the analysis. Cognitive performance scores and PP showed significant differences across time. After adjustment for the confounders, the standardized coefficients of PP in the LGM indicated negative effects on cognitive performance in elderly Chinese participants at wave 2 and wave 3 (P < 0.01). The initial level of PP in the unconditional model was negatively associated with the initial level (β = − 0.25) and the slope (β = − 0.16) of cognition, whereas these effects were attenuated and the association between intercept of PP and slope of cognition became nonsignificant after controlling for the confounders. Conclusions The implications of these results demonstrate that a higher PP lowers the cognitive performance of middle-aged and elderly persons independent of a comprehensive set of covariates, but it is not a contributor to the rate of change in cognition.
机译：摘要背景实质证据表明血压（BP）措施与认知功能之间的关系不一致，复杂，年龄相关。脉冲压力（PP），其不仅反映动脉僵硬，而且还代表了BP本身以外的高血压的慢性效应，被认为是认知障碍的更好预测因素。但是，关于对PP的认知功能协会的证据尚未得到广泛研究。基于潜伏生长模型（LGM），我们在纵向研究中审查了这种关系。方法本研究基于来自中国卫生和退休纵向研究（CHARL）的中国中年和老年人参与者的全国代表性，从2011年到2016年进行了一项预期的观察研究。根据三项措施评估认知表现认知。 PP被计算为三种收缩性和舒张BP读数的平均值的差异。在这项研究中收集了一系列潜在的混乱。 LGM用于在三个时间点检查PP对认知性能的影响。为了测试PP对初始水平的独立效果以及随后的认知，无条件和条件模型的后续发展。结果除了缺少关键变量的受访者之后，我们最终包括9750名参与者在分析中。认知性能分数和PP在时间上显示出显着的差异。在对混凝剂进行调整后，LGM中PP的标准化系数对波2和Wave 3的老年人参与者的认知性能表示负面影响（P <0.01）。无条件模型中PP的初始水平与认知的初始水平（β= -0.25）和斜率（β= -0.16）负相关，而这些效果被衰减，并且PP与认知坡度之间的关联在控制混乱后，却变得无情。结论这些结果的含义表明，更高的PP降低了独立于一系列全面的协变量的中年和老年人的认知性能，但这不是认知变化率的贡献者。

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