不同血压控制水平对高龄患者脑血流量及脑萎缩风险的影响OA

Objective To investigate the effects of different blood pressure control strategies on cerebral blood flow and cer-ebral atrophy risk in elderly patients.Methods A total of 200 patients(aged≥80 years)with primary hypertension,diagnosed and treated at the People's Hospital of Xinjiang Uygur Autonomous Region between June 2022 and December 2023,were selected as the study subjects.They were randomly divided into an observation group and a control group using a random number table,with 100 pa-tients in each group.All patients received interventions based on different blood pressure control targets:the observation group was re-quired to achieve a systolic blood pressure≤120 mmHg(1 mmHg=0.133 kPa),while the control group was to maintain a systolic blood pressure between 120 mmHg and 140 mmHg.Both groups were followed up for one year to analyze cerebral blood flow and cere-bral atrophy status at the time of target achievement and one year thereafter.Results As of December 31,2024,one year after reac-hing the target standard,137 cases completed follow-up,including 66 in the control group and 71 in the observation group.The systol-ic blood pressure and diastolic blood pressure of patients in the observation group after intervention were significantly lower than those in the control group(P<0.001).There were no statistically significant differences in the mean flow velocity(Vm),peak systolic veloci-ty(Vs),pulsatility index(PI)of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),and vertebral artery(VA)detected via the transoccipital window in the prone position between the two groups after blood pressure control(P>0.05).One year after reaching the standard,the Vm,Vs,and PI values of each cerebral vessel decreased in both the control and observation groups compared to the values at the time of standard achievement,and the Vm,Vs,and PI in the ob-servation group were lower than those in the control group(P<0.05).One year after standard achievement,there was no statistically significant difference in white matter lesion(WML)volume in the observation group compared to that at the time of standard achieve-ment(P>0.05).However,one year after standard achievement,the WML volume in the control group was greater than that at the time of standard achievement,and the WML volume in the control group was also greater than that in the observation group(P<0.05).There were no statistically significant differences between the two groups in the incidence of stroke-related diseases,acute coro-nary syndrome,hepatic or renal impairment,or ischemic syncope(P>0.05).Conclusion Intensive antihypertensive therapy can reduce cerebral blood flow,prevent brain volume decreasing and WML volume increase in elderly patients,and the safety is relatively good.