The effect of antihypertensive treatment on white matter lesions and cognitive dysfunction in elderly patients with isolated systolic hypertension and discussion of optimal target systolic blood pressure
Huang Qin
Ma Lixia
Liu Sha
Chu Limin
Wang Xiaojing
Cao Li
Wei Shulin
Abstract：Objective To investigate the effect of antihypertensive treatment on white matter lesions (WML) and cognitive dysfunction (CD) in elderly patients (≥65y) with isolated systolic hypertension (SBP) and the optimal target systolic blood pressure (ISH). Methods 457 elderly patients (≥65y) with ISH from January to December 2017 were enrolled into the study and followed up for three years. Patients' cognitive status was assessed using the Mini-Mental Condition Check Scale (MMSE), and systolic blood pressure (SBP) decline and absolute value of white matter high signal volume (WMH) and Correlation between WMH and total brain volume (TIV) were assessed by local weighted regression scatter (LOWESS). Results After 3 years of follow-up, the number of patients drinking and smoking was significantly reduced. SBP, diastolic blood pressure (DBP), fasting blood glucose (FPG), and MMSE were lower than those before treatment, while WMH and WMH/TIV were higher than baseline (P<0.05). Compared with patients with SBP decrease <10 mmHg, the WMH rate of patients with SBP decreased by 21~30 mmHg and 31~40 mmHg group was lower, the difference was statistically significant (P<0.05); SBP decreased by 11~20 mmHg, 21~30 mmHg, the change rate of WMH/TIV in patients with 31~40mmHg and 41~50 mmHg group was lower, and the difference was statistically significant (P<0.05). Compared with patients with SBP<130 mmHg group, patients with SBP 141~150mmHg group and 151~160 mmHg group had lower WMH rate, the difference was statistically significant (P<0.05); SBP decreased 141~150 mmHg group patients had lower WMH/TIV rate, and the difference was statistically significant (P<0.05). Conclusion Elderly patients with isolated systolic hypertension can delay white matter damage and cognitive dysfunction when receiving antihypertensive therapy. The optimal SBP target value is controlled at 141~150 mmHg, and the SBP decrease is controlled at 21~40 mmHg.
Keywords：Isolated systolic hypertensionAntihypertensive treatmentWhite matter lesionsCognitive dysfunctionApnea-hypopnea index
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1358-1361 )