动脉高血压是脑小血管病和血管性认知障碍的主要可改变危险因素。慢性血压升高会导致内皮功能障碍、血脑屏障破坏、白质损伤和进行性认知下降。本研究旨在评估不同高血压分期患者中磁共振成像检测的白质高信号与认知障碍之间的关系。共检查了120名年龄45-70岁的患者。认知功能采用蒙特利尔认知评估量表进行评估，MRI结果采用Fazekas量表分级进行分析。结果发现白质高信号严重程度与MoCA评分降低之间存在统计学显著相关性（r = -0.62, p < 0.01）。研究结果证实，长期高血压会导致与执行功能障碍和加工速度减慢相关的结构性脑血管变化。对高血压患者进行早期神经影像学和认知筛查可改善血管性痴呆的预防策略。
参考文献：
- Iadecola C., Gottesman R.F. Neurovascular and cognitive dysfunction in hypertension. Hypertension. 2021;78(5):1200-1211.
- Wardlaw J.M., et al. Cerebral small vessel disease: mechanisms and clinical implications. Lancet Neurology. 2023;22(7):684-697.
- Williamson J.D., et al. Intensive blood pressure control and cognitive outcomes. New England Journal of Medicine. 2021;385:1783-1793.
- Ungvari Z., et al. Hypertension-induced microvascular dysfunction and cognitive decline. Journal of Cerebral Blood Flow & Metabolism. 2022;42(6):1089-1103.
- Gorelick P.B., et al. Vascular contributions to cognitive impairment and dementia. Stroke. 2022;53(3):e55-e67.
- van Leijsen E.M.C., et al. MRI markers of small vessel disease and cognition. Brain. 2023;146(2):512-524.
- Angadi SS, Jarrett CL, Sherif M, Gaesser GA, Mookadam F (2017) The effect of exercise training on biventricular myocardial strain in heart failure with preserved ejection fraction. Eur Soc Cardiol Heart Failure 4:356–359.
- Au JS, Oikawa SY, Morton RW, Phillips SM, MacDonald MJ, Stöhr EJ (2019) Unaltered left ventricular mechanics and remodelling after 12 weeks of resistance exercise training–a longitudinal study in men. Appl Physiol, Nutr, Metab 44:820–826.
- Biering-Sørensen T, Biering-Sørensen SR, Olsen FJ, Sengeløv M, Jørgensen PG, Mogelvang R, Shah AM, Jensen JS (2017) Global longitudinal strain by echocardiography predicts long-term risk of cardiovascular morbidity and mortality in a low-risk general population: the Copenhagen City Heart Study. Circulation: Cardiovascular Imaging 10:e005521.
- Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2010) A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods 1:97–111.
- Cadeddu C, Nocco S, Cugusi L, Deidda M, Fabio O, Bandino S, Cossu E, Incani M, Baroni MG, Mercuro G (2016) Effects of metformin and exercise training, alone or in combination, on cardiac function in individuals with insulin resistance. Cardiology and Therapy 5:63–73.
- Cohen J (2013) Statistical power analysis for the behavioral sciences. Academic press.
- D’Elia N, Caselli S, Kosmala W, Lancellotti P, Morris D, Muraru D, Takeuchi M, van den Bosch A, van Grootel RW, Villarraga H (2020) Normal global longitudinal strain: an individual patient meta-analysis. Cardiovascular Imaging 13:167–169.
- Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. Brit Med J 315:629–634.
- Enrico M, Klika R, Ingletto C, Mascherini G, Pedrizzetti G, Stefani L (2018) Changes in global longitudinal strain in renal transplant recipients following 12 months of exercise. Intern Emerg Med 13:805–809.
- European Heart Network (2017) European Cardiovascular Disease Statistics 2017.
- European Journal of Applied Physiology (2022) 122:1397–1408.
- Eyre H, Kahn R, Robertson RM, Committee AAACW, Members AAA CWC, Clark NG, Doyle C, Hong Y, Gansler T, Glynn T (2004) Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American cancer society, the American diabetes association, and the American heart association. Circulation 109:3244–3255.
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