Association between cognitive impairments and blood pressure variability during the day/night cycle in elderly patients treated with hemodialysis
10.3760/cma.j.issn.0254-9026.2018.06.002
- VernacularTitle:老年血液透析患者昼夜血压变异度与认知功能相关性的临床研究
- Author:
Yidan GUO
1
;
Chunxia ZHANG
;
Yang LUO
Author Information
1. 100038,首都医科大学附属北京世纪坛坛医院肾内科
- Keywords:
Renal dialysis;
Cognitive function;
Blood pressure variability
- From:
Chinese Journal of Geriatrics
2018;37(6):612-615
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between cognitive impairments in elderly patients receiving hemodialysis and blood pressure variability during the day/night cycle. Methods A cross-sectional study was performed in 106 hemodialysis patients to evaluate cognitive function with Montreal Cognitive Assessment (MoCA) and blood pressure variability with a 24 h ambulatory blood pressure monitor. A multi-Logistic regression was conducted to analyze potential risk factors associated with cognitive impairments. Results A hundred and six patients had an average age of (73.1 ± 12.9)years.Sixty-nine out of 106 (63.4%) suffered cognitive impairments with MoCA scores lower than 26. Measurements for patients with cognitive impairments versus patients without cognitive impairments included twenty-four-hour ambulatory blood systolic pressure[(151.3 ± 20.1)mmHg vs. (131.1±11.7)mmHg ,P＜ 0.05],day-time average systolic blood pressure[(167.6±28.2)mmHg vs.(139.1 ± 14.2)mmHg ,P ＜ 0.05] ,night-time average systolic blood pressure [(139.9 ± 18.5) mmHg vs.(100.2± 11.3)mmHg ,P＜ 0.05] ,difference in systolic blood pressure between day and night[(167.6 ± 28.2)mmHg vs. (139.1 ± 14.2)mmHg ,P＜ 0.05] ,and coefficient of variation of systolic blood pressure [(8.2 ± 1.6)% vs. (19.9 ± 2.9)%,χ2＝ 44.67 ,P ＜ 0.05].Multi-logistic regression analysis showed that age (OR :1.5 ,95% CI :1.1-2.2 ,P＜0.05) ,education level (OR :1.8 , 95% CI :1.4-2.5 ,P＜0.05) ,anemia (OR :1.7 ,95% CI :1.1-2.6 ,P＜0.05) ,and diabetes (OR :2.1 , 95% CI :1.7-3.1 ,P＜0.05) were associated with cognitive impairments.Moreover ,the coefficient of variation of systolic blood pressure was also independently correlated with cognitive impairments (OR :1.4 ,95% CI :1.1-1.9 ,P＜0.05). Conclusions Cognitive impairment has a high prevalence among elderly hemodialysis patients and is associated with anemia ,age ,education level ,hypertension and diabetes.Besides ,the coefficient of variation of low systolic blood pressure may be an independent risk factor for cognitive impairment.
