Analysis on the influencing factors of elderly hypertensive patients with cognitive dysfunction / 中国综合临床

ABSTRACT

Objective To investigate the influencing factors of cognitive dysfunction in elderly patients with hypertension.Methods From October 2015 to October 2016,one hundred and fifty-one elderly hypertensive patients treated in the Affiliated Hospital of North China University of Science and Technologywere selected as the observation group,and 151 healthy subjects in the same period were enrolled in the control group.The blood pressure measurement and cognitive function evaluation were given to analyze the influencing factors of elderly hypertensive patients with cognitive dysfunction.Results Diastolic pressure ((98.5 ±4.2) mmHg),systolic pressure ((157.6 ± 8.9) mmHg),pulse pressure ((59.1 ± 4.3) mmHg) and cognitive impairment rate(27.2％) in observation group were higher than those in the control group((82.7±3.6 mmHg,(122.4± 6.8) mmHg,(39.7 ± 2.5) mmHg,0.0％),the differences were statistically significant (t =4.951,5.868,8.128,P＜ 0.05).The language fluency ((2.5 ± 0.2) points),memory ability ((2.7 ± 0.4) points),visual spatial executive ability ((2.9±0.2) points),naming ability ((2.6±0.1 points),abstract generalization ability ((1.7±0.2) points),orientation ability ((5.0 ± 0.4) points),attention and calculation ability ((5.1 ±0.3) points),total score ((22.5±0.8) points)in observation group were lower than those in the control group ((2.8±0.1) points,(4.8 ± 0.2) points,(4.7 ± 0.3) points,(2.8 ± 0.2) points,(1.9 ± 0.1) points,(5.7 ±0.1) points,(5.7±0.2) points,(28.4±0.6) points) (t=4.202,10.778,9.206,3.769,4.173,4.405,4.278,5.727,P＜0.05).Diastolic pressure ((103.7 ± 2.5)mmHg),systolic pressure ((164.8 ±4.1) mmHg),pulse pressure((64.5± 1.6) mmHg)in patients with cognitive dysfunction were higher than those in patients without cognitive dysfunction ((92.6±2.8) mmHg,(145.7±3.9) mmHg,(46.3± 1.5) mmHg) (t =4.195,4.310,6.913,P＜0.05).Age distribution (≤65 years old in 9 cases,＞65 years old in 32 cases),BMI index distribution (≤24 kg/m2 in 11 cases,＞24 kg/m2 in 30 cases) in patients without cognitive dysfunction were better than those in patients with cognitive dysfunction ((≤ 65 yeas old in 64 cases,＞ 65 years old in 46 cases),(≤ 24 kg/m2 in 68 cases,＞ 24 kg/m2 in 42 cases)).The differences were statistically significant (x2 =15.700,14.657,P ＜ 0.05).Multiple linear regression analysis showed that cognitive function in elderly hypertensive patients was related to age,BMI index,diastolic blood pressure and pulse pressure (OR (95％CI)4.265 (2.038 ～ 8.927),3.991 (1.956～8.142),3.294 (1.532 ～ 7.084),3.521 (1.640 ～ 7.561),5 (2.375 ～10.528);P=0.000).Condusion Age,BMI index,diastolic blood pressure,systolic blood pressure,pulse pressure are influencing factors in elderly hypertension patients with cognitive dysfunction.