脉压与认知障碍关系的研究进展OA

Pulse pressure(PP),an indicator of arterial stiffness and pulsatile hemodynamic load,may offer superior value in risk assessment compared to static blood pressure indices.Recent studies have reported an association between PP and cognitive impairment or dementia;however,the findings have been inconsistent.This review summarizes the current evidence on the association between PP and cognitive impairment,with particular emphasis on its overall relationship with cognitive function,the modifying effects of age,sex,and APOE ε4 genotype,and the potential underlying mechanisms.Current evidence suggests that persistently elevated PP is associated with an increased risk of cognitive decline,and this association may be partly independent of traditional blood pressure indices and common vascular risk factors.Mechanistically,elevated PP may promote excessive transmission of pulsatile energy into the cerebral microcirculation,leading to perfusion mismatch,impaired cerebral autoregulation,and disruption of the blood-brain barrier.It may also contribute to cerebral small vessel remodeling,white matter microstructural damage,neuroinflammation,and impaired clearance of pathological proteins such as amyloid beta(Aβ)and tau,ultimately compromising brain network integrity and cognitive function.Given its noninvasive,simple,low-cost,and repeatable nature,PP may serve as a useful adjunctive marker for the early identification,risk stratification,and clinical assessment of individuals at high risk of cognitive impairment.However,its risk thresholds,causal relationship with cognitive decline,and therapeutic implications still require further investigation.