Influencing factors of cognitive impairment in patients with hypertension: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHAO Ziran ¹ , YANG Xiaoli ¹ , GUO Honghua ¹ , XIA Yan ¹ , LI Wen ² , TAN Chunmiao ³ ,  ZHANG Caihong ¹

1. School of International Nursing, Hainan Medical University, Haikou 571199, P. R. China;
2. Nursing Homes in Hainan Province, Haikou 570100, P. R. China;
3. Department of Geriatrics, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, P. R. China;

Corresponding?author：

ZHANG Caihong, Email: 404669792@qq.com

Keywords：

Hypertension; Cognitive impairment; Influencing factors; Meta-analysis

DOI：

10.7507/1672-2531.202307129

Video：

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Objective To systematically review the factors for cognitive impairment in hypertensive patients. Methods PubMed, Web of Science, Embase, Cochrane Library, Ovid, Scopus, EBSCO, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software. Results A total of 26 articles involving 13 464 patients were included. The results of meta-analysis showed that antihypertensive drug use (OR=0.22, 95%CI 0.09 to 0.59, P=0.002), blood pressure was well controlled (OR=0.48, 95%CI 0.37 to 0.623, P<0.001), and social support (OR=0.94, 95%CI 0.90 to 0.97, P<0.001) were protective factors for CI in hypertensive patients. And age (OR=1.17, 95%CI 1.12 to 1.22, P<0.001), age ≥60 (OR=2.10, 95%CI 1.71 to 2.57, P<0.001), female (OR=1.55, 95%CI 1.25 to 1.93, P<0.001), single (OR=2.39, 95%CI 1.89 to 3.03, P<0.001), smoking (OR=3.40, 95%CI 2.40 to 4.82, P < 0.001), educational level (<college） (OR=3.46, 95%CI 2.73 to 4.39, P<0.001), education years (≥12 years) (OR=2.10, 95%CI 1.43 to 3.07, P<0.001), diabetes (OR=2.82, 95%CI 2.22 to 3.58, P<0.001), hyperlipidemia (OR=1.48, 95%CI 1.10 to 2.00, P=0.01), total cholesterol (OR=1.11, 95%CI 1.01 to 1.22, P=0.02), CVHI anomalies (OR=6.24, 95%CI 3.75 to 10.37, P<0.001), sleep disorder (OR=2.92, 95%CI 1.93 to 4.42, P<0.001), systolic blood pressure (OR=1.04, 95%CI 1.02 to 1.06, P<0.001), orthostatic hypotension (OR=1.39, 95%CI 1.20 to 1.62, P<0.001, grade 2 hypertension (OR=2.62,95%CI 1.83 to 3.73, P<0.001), grade 3 hypertension (OR=3.15, 95%CI 1.90 to 5.22, P<0.001), stress history (OR=4.57, 95%CI 2.86 to 7.30, P<0.001) were all risk factors. Conclusion The current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients, and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more comprehensive in the future.

Citation： ZHAO Ziran, YANG Xiaoli, GUO Honghua, XIA Yan, LI Wen, TAN Chunmiao, ZHANG Caihong. Influencing factors of cognitive impairment in patients with hypertension: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2024, 24(5): 577-583. doi: 10.7507/1672-2531.202307129 Copy

1.	李蘇寧, 陳祚, 王增武, 等. 我國老年人高血壓現狀分析. 中華高血壓雜志, 2019, 27(2): 140-148.
2.	Qin J, He Z, Wu L, et al. Prevalence of mild cognitive impairment in patients with hypertension: a systematic review and meta-analysis. Hypertens Res, 2021, 44(10): 1251-1260.
3.	Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health, 2020, 5(12): 661-671.
4.	胡亦新, 郭藝芳, 王磊. 老年高血壓合并認知障礙診療中國專家共識(2021版). 中華高血壓雜志, 2021, 29(4): 311-322.
5.	Santisteban MM, Iadecola C, Carnevale D. Hypertension, neurovascular dysfunction, and cognitive impairment. Hypertension, 2023, 80(1): 22-34.
6.	Ungvari Z, Toth P, Tarantini S, et al. Hypertension-induced cognitive impairment: from pathophysiology to public health. Nat Rev Nephrol, 2021, 17(10): 639-654.
7.	Castilla-Guerra L. Late-life hypertension as a risk factor for cognitive decline and dementia. Hypertens Res, 2022, 45(10): 1670-1671.
8.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
10.	趙麗潔, 武宏, 霍秀紅. 高血壓患者海馬體積和腦血管反應性與認知功能減退的相關性. 中華高血壓雜志, 2021, 29(6): 562-566.
11.	尉鑫慧. 基于血壓變異性的老年高血壓患者認知功能減退風險預測. 呼和浩特: 內蒙古醫科大學, 2021.
12.	傅衛紅, 謝柏梅, 張彥海, 等. 軍隊離退休老年高血壓患者認知功能障礙的危險因素. 中華高血壓雜志, 2014, 22(6): 559-563.
13.	金鑫. 老年高血壓患者認知功能與微量白蛋白尿的關系. 石家莊: 河北醫科大學, 2010.
14.	李晗. 老年高血壓患者認知功能障礙的臨床特點及其相關因素研究. 太原: 山西醫科大學, 2021.
15.	劉澤源. 老年高血壓患者認知功能障礙的影響因素及相關分析. 長春: 吉林大學, 2021.
16.	何志蘭. 老年高血壓患者睡眠質量對認知功能障礙的影響. 合肥: 安徽醫科大學, 2020.
17.	周波, 汪芳軍, 金龐, 等. 原發性高血壓患者認知功能障礙與血清Klotho蛋白濃度的關聯. 中華高血壓雜志, 2020, 28(4): 374-377.
18.	Zhuo X, Huang M, Wu M. Analysis of cognitive dysfunction and its risk factors in patients with hypertension. Medicine (Baltimore), 2022, 101(10): e28934.
19.	Yamamoto K, Akasaka H, Yasunobe Y, et al. Clinical characteristics of older adults with hypertension and unrecognized cognitive impairment. Hypertens Res, 2022, 45(4): 612-619.
20.	Peters R, Anstey KJ, Booth A, et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. Eur Heart J, 2018, 39(33): 3135-3143.
21.	馬萬瑞, 李漫娜, 王立群, 等. ≥55歲高血壓患者發生輕度認知功能障礙的影響因素研究. 中國全科醫學, 2023, 26(9): 1075-1079,1085.
22.	葉青芳, 王旖旎, 李玲, 等. 中青年高血壓住院患者輕度認知功能障礙發生現狀及影響因素研究. 中國全科醫學, 2023, 26(2): 154-159,167.
23.	陳玲, 楊連招, 陸靜鈺, 等. 南寧市社區老年高血壓患者輕度認知障礙現狀及影響因素研究. 中華護理教育, 2022, 19(6): 566-571.
24.	秦虹云, 諸秉根, 王玲, 等. 新發和不治療高血壓對社區輕度認知功能障礙老年人認知功能影響的隨訪調查. 中國全科醫學, 2020, 23(13): 1640-1646,1653.
25.	陸靜鈺. 社區老年高血壓患者輕度認知功能障礙影響因素及風險預測模型構建. 南寧: 廣西中醫藥大學, 2021.
26.	謝玉芳, 楊鳳, 黃小紅, 等. 老年高血壓患者合并腦血管血流動力學異常對輕度認知功能障礙的影響. 中國現代醫生, 2021, 59(32): 117-120.
27.	宋彥麗, 林杰, 夏文靜, 等. 同型半胱氨酸與高血壓患者輕度認知障礙的相關性. 中國卒中雜志, 2020, 15(12): 1322-1326.
28.	葛婷愛, 周逸丹, 王賽英, 等. 老年高血壓患者合并腦血管血流動力學異常對輕度認知功能障礙的影響. 中華高血壓雜志, 2018, 26(6): 582-585.
29.	余科, 祁風, 劉祖佑, 等. 高血壓患者輕度認知功能障礙與大腦中動脈狹窄的關系及危險因素. 中華全科醫學, 2017, 15(4): 614-616.
30.	Yan X, Meng T, Liu H, et al. The association between the duration, treatment, control of hypertension and lifestyle risk factors in middle-aged and elderly patients with mild cognitive impairment: a case-control study. Neuropsychiatr Dis Treat, 2022, 18: 585-595.
31.	Ma L, Feng M, Qian Y, et al. Insulin resistance is an important risk factor for cognitive impairment in elderly patients with primary hypertension. Yonsei Med J, 2015, 56(1): 89-94.
32.	Wu L, He Y, Jiang B, et al. The association between the prevalence, treatment and control of hypertension and the risk of mild cognitive impairment in an elderly urban population in China. Hypertens Res, 2016, 39(5): 367-375.
33.	Solfrizzi V, Scafato E, Frisardi V, et al. Angiotensin-converting enzyme inhibitors and incidence of mild cognitive impairment. The Italian longitudinal study on aging. Age (Dordr), 2013, 35(2): 441-453.
34.	李倩, 趙建華, 彭雪, 等. H型高血壓患者血尿酸水平與輕度認知功能障礙的相關性分析. 中國全科醫學, 2021, 24(20): 2527-2531.
35.	Pallangyo P, Mkojera ZS, Komba M, et al. Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study. BMC Neurol, 2021, 21(1): 433.
36.	Wei J, Yin X, Liu Q, et al. Association between hypertension and cognitive function: a cross-sectional study in people over 45 years old in China. J Clin Hypertens (Greenwich), 2018, 20(11): 1575-1583.
37.	Hou Q, Guan Y, Liu X, et al. Development and validation of a risk model for cognitive impairment in the older Chinese inpatients: an analysis based on a 5-year database. J Clin Neurosci, 2022, 104: 29-33.
38.	Corley E, Fahey L, Fitzgerald J, et al. The impact of early adversity and education on genetic and brain morphological predictors of cognitive ability. Genes Brain Behav, 2023, 22(4): e12850.
39.	Miyawaki CE, Liu M. Gender differences in cognitive impairment among the old and the oldest-old in China. Geriatr Gerontol Int, 2019, 19(7): 586-592.
40.	Oremus M, Konnert C, Law J, et al. Social support and cognitive function in middle- and older-aged adults: descriptive analysis of CLSA tracking data. Eur J Public Health, 2019, 29(6): 1084-1089.
41.	Magrin ME, D'Addario M, Greco A, et al. Social support and adherence to treatment in hypertensive patients: a meta-analysis. Ann Behav Med, 2015, 49(3): 307-318.
42.	Gardener H, Levin B, DeRosa J, et al. Social connectivity is related to mild cognitive impairment and dementia. J Alzheimers Dis, 2021, 84(4): 1811-1820.
43.	Kato K, Noda A, Yasuma F, et al. Effects of sleep-disordered breathing and hypertension on cognitive function in elderly adults. Clin Exp Hypertens, 2020, 42(3): 250-256.
44.	Baril AA, Beiser AS, Sanchez E, et al. Insomnia symptom severity and cognitive performance: moderating role of APOE genotype. Alzheimers Dement, 2022, 18(3): 408-421.
45.	Wang T, Zhang X, Wang Y, et al. High cholesterol and 27-hydroxycholesterol contribute to phosphorylation of tau protein by impairing autophagy causing learning and memory impairment in C57BL/6J mice. J Nutr Biochem, 2022, 106: 109016.
46.	Xue M, Xu W, Ou YN, et al. Diabetes mellitus and risks of cognitive impairment and dementia: a systematic review and meta-analysis of 144 prospective studies. Ageing Res Rev, 2019, 55: 100944.
47.	Nagai M, Dote K, F?rster CY. Is unrecognized cognitive impairment in hypertension unmasked by diabetes mellitus. Hypertens Res, 2022, 45(6): 1082-1084.
48.	Biessels GJ, Despa F. Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol, 2018, 14(10): 591-604.
49.	Dai L, Zou L, Meng L, et al. Cholesterol metabolism in neurodegenerative diseases: molecular mechanisms and therapeutic targets. Mol Neurobiol, 2021, 58(5): 2183-2201.
50.	Bailey TG, Klein T, Meneses AL, et al. Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment. Eur J Appl Physiol, 2022, 122(8): 1843-1856.
51.	Yew B, Nation DA. Cerebrovascular resistance: effects on cognitive decline, cortical atrophy, and progression to dementia. Brain, 2017, 140(7): 1987-2001.
52.	Seitz KI, Ehler N, Schmitz M, et al. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: association with childhood trauma. Br J Clin Psychol, 2022, 61(3): 680-700.
53.	Alves de Araujo Junior D, Sair HI, Peters ME, et al. The association between post-traumatic stress disorder (PTSD) and cognitive impairment: a systematic review of neuroimaging findings. J Psychiatr Res, 2023, 164: 259-269.
54.	Zhou TL, Kroon AA, van Sloten TT, et al. Greater blood pressure variability is associated with lower cognitive performance. Hypertension, 2019, 73(4): 803-811.
55.	Novak V, Hajjar I. The relationship between blood pressure and cognitive function. Nat Rev Cardiol, 2010, 7(12): 686-698.
56.	Hughes D, Judge C, Murphy R, et al. Association of blood pressure lowering with incident dementia or cognitive impairment: a systematic review and meta-analysis. JAMA, 2020, 323(19): 1934-1944.
57.	Gouveia F, Camins A, Ettcheto M, et al. Targeting brain renin-angiotensin system for the prevention and treatment of Alzheimer's disease: past, present and future. Ageing Res Rev, 2022, 77: 101612.
58.	Rawle MJ, Cooper R, Kuh D, et al. Associations between polypharmacy and cognitive and physical capability: a British birth cohort study. J Am Geriatr Soc, 2018, 66(5): 916-923.
59.	Mancia G, Hall J E. Introduction to a compendium on the pathophysiology and treatment of hypertension. Circ Res, 2019, 124(7): 967-968.
60.	Xia H, Du X, Yin G, et al. Effects of smoking on cognition and BDNF levels in a male Chinese population: relationship with BDNF Val66Met polymorphism. Sci Rep, 2019, 9(1): 217.

1. 李蘇寧, 陳祚, 王增武, 等. 我國老年人高血壓現狀分析. 中華高血壓雜志, 2019, 27(2): 140-148.
2. Qin J, He Z, Wu L, et al. Prevalence of mild cognitive impairment in patients with hypertension: a systematic review and meta-analysis. Hypertens Res, 2021, 44(10): 1251-1260.
3. Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health, 2020, 5(12): 661-671.
4. 胡亦新, 郭藝芳, 王磊. 老年高血壓合并認知障礙診療中國專家共識(2021版). 中華高血壓雜志, 2021, 29(4): 311-322.
5. Santisteban MM, Iadecola C, Carnevale D. Hypertension, neurovascular dysfunction, and cognitive impairment. Hypertension, 2023, 80(1): 22-34.
6. Ungvari Z, Toth P, Tarantini S, et al. Hypertension-induced cognitive impairment: from pathophysiology to public health. Nat Rev Nephrol, 2021, 17(10): 639-654.
7. Castilla-Guerra L. Late-life hypertension as a risk factor for cognitive decline and dementia. Hypertens Res, 2022, 45(10): 1670-1671.
8. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
10. 趙麗潔, 武宏, 霍秀紅. 高血壓患者海馬體積和腦血管反應性與認知功能減退的相關性. 中華高血壓雜志, 2021, 29(6): 562-566.
11. 尉鑫慧. 基于血壓變異性的老年高血壓患者認知功能減退風險預測. 呼和浩特: 內蒙古醫科大學, 2021.
12. 傅衛紅, 謝柏梅, 張彥海, 等. 軍隊離退休老年高血壓患者認知功能障礙的危險因素. 中華高血壓雜志, 2014, 22(6): 559-563.
13. 金鑫. 老年高血壓患者認知功能與微量白蛋白尿的關系. 石家莊: 河北醫科大學, 2010.
14. 李晗. 老年高血壓患者認知功能障礙的臨床特點及其相關因素研究. 太原: 山西醫科大學, 2021.
15. 劉澤源. 老年高血壓患者認知功能障礙的影響因素及相關分析. 長春: 吉林大學, 2021.
16. 何志蘭. 老年高血壓患者睡眠質量對認知功能障礙的影響. 合肥: 安徽醫科大學, 2020.
17. 周波, 汪芳軍, 金龐, 等. 原發性高血壓患者認知功能障礙與血清Klotho蛋白濃度的關聯. 中華高血壓雜志, 2020, 28(4): 374-377.
18. Zhuo X, Huang M, Wu M. Analysis of cognitive dysfunction and its risk factors in patients with hypertension. Medicine (Baltimore), 2022, 101(10): e28934.
19. Yamamoto K, Akasaka H, Yasunobe Y, et al. Clinical characteristics of older adults with hypertension and unrecognized cognitive impairment. Hypertens Res, 2022, 45(4): 612-619.
20. Peters R, Anstey KJ, Booth A, et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. Eur Heart J, 2018, 39(33): 3135-3143.
21. 馬萬瑞, 李漫娜, 王立群, 等. ≥55歲高血壓患者發生輕度認知功能障礙的影響因素研究. 中國全科醫學, 2023, 26(9): 1075-1079,1085.
22. 葉青芳, 王旖旎, 李玲, 等. 中青年高血壓住院患者輕度認知功能障礙發生現狀及影響因素研究. 中國全科醫學, 2023, 26(2): 154-159,167.
23. 陳玲, 楊連招, 陸靜鈺, 等. 南寧市社區老年高血壓患者輕度認知障礙現狀及影響因素研究. 中華護理教育, 2022, 19(6): 566-571.
24. 秦虹云, 諸秉根, 王玲, 等. 新發和不治療高血壓對社區輕度認知功能障礙老年人認知功能影響的隨訪調查. 中國全科醫學, 2020, 23(13): 1640-1646,1653.
25. 陸靜鈺. 社區老年高血壓患者輕度認知功能障礙影響因素及風險預測模型構建. 南寧: 廣西中醫藥大學, 2021.
26. 謝玉芳, 楊鳳, 黃小紅, 等. 老年高血壓患者合并腦血管血流動力學異常對輕度認知功能障礙的影響. 中國現代醫生, 2021, 59(32): 117-120.
27. 宋彥麗, 林杰, 夏文靜, 等. 同型半胱氨酸與高血壓患者輕度認知障礙的相關性. 中國卒中雜志, 2020, 15(12): 1322-1326.
28. 葛婷愛, 周逸丹, 王賽英, 等. 老年高血壓患者合并腦血管血流動力學異常對輕度認知功能障礙的影響. 中華高血壓雜志, 2018, 26(6): 582-585.
29. 余科, 祁風, 劉祖佑, 等. 高血壓患者輕度認知功能障礙與大腦中動脈狹窄的關系及危險因素. 中華全科醫學, 2017, 15(4): 614-616.
30. Yan X, Meng T, Liu H, et al. The association between the duration, treatment, control of hypertension and lifestyle risk factors in middle-aged and elderly patients with mild cognitive impairment: a case-control study. Neuropsychiatr Dis Treat, 2022, 18: 585-595.
31. Ma L, Feng M, Qian Y, et al. Insulin resistance is an important risk factor for cognitive impairment in elderly patients with primary hypertension. Yonsei Med J, 2015, 56(1): 89-94.
32. Wu L, He Y, Jiang B, et al. The association between the prevalence, treatment and control of hypertension and the risk of mild cognitive impairment in an elderly urban population in China. Hypertens Res, 2016, 39(5): 367-375.
33. Solfrizzi V, Scafato E, Frisardi V, et al. Angiotensin-converting enzyme inhibitors and incidence of mild cognitive impairment. The Italian longitudinal study on aging. Age (Dordr), 2013, 35(2): 441-453.
34. 李倩, 趙建華, 彭雪, 等. H型高血壓患者血尿酸水平與輕度認知功能障礙的相關性分析. 中國全科醫學, 2021, 24(20): 2527-2531.
35. Pallangyo P, Mkojera ZS, Komba M, et al. Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study. BMC Neurol, 2021, 21(1): 433.
36. Wei J, Yin X, Liu Q, et al. Association between hypertension and cognitive function: a cross-sectional study in people over 45 years old in China. J Clin Hypertens (Greenwich), 2018, 20(11): 1575-1583.
37. Hou Q, Guan Y, Liu X, et al. Development and validation of a risk model for cognitive impairment in the older Chinese inpatients: an analysis based on a 5-year database. J Clin Neurosci, 2022, 104: 29-33.
38. Corley E, Fahey L, Fitzgerald J, et al. The impact of early adversity and education on genetic and brain morphological predictors of cognitive ability. Genes Brain Behav, 2023, 22(4): e12850.
39. Miyawaki CE, Liu M. Gender differences in cognitive impairment among the old and the oldest-old in China. Geriatr Gerontol Int, 2019, 19(7): 586-592.
40. Oremus M, Konnert C, Law J, et al. Social support and cognitive function in middle- and older-aged adults: descriptive analysis of CLSA tracking data. Eur J Public Health, 2019, 29(6): 1084-1089.
41. Magrin ME, D'Addario M, Greco A, et al. Social support and adherence to treatment in hypertensive patients: a meta-analysis. Ann Behav Med, 2015, 49(3): 307-318.
42. Gardener H, Levin B, DeRosa J, et al. Social connectivity is related to mild cognitive impairment and dementia. J Alzheimers Dis, 2021, 84(4): 1811-1820.
43. Kato K, Noda A, Yasuma F, et al. Effects of sleep-disordered breathing and hypertension on cognitive function in elderly adults. Clin Exp Hypertens, 2020, 42(3): 250-256.
44. Baril AA, Beiser AS, Sanchez E, et al. Insomnia symptom severity and cognitive performance: moderating role of APOE genotype. Alzheimers Dement, 2022, 18(3): 408-421.
45. Wang T, Zhang X, Wang Y, et al. High cholesterol and 27-hydroxycholesterol contribute to phosphorylation of tau protein by impairing autophagy causing learning and memory impairment in C57BL/6J mice. J Nutr Biochem, 2022, 106: 109016.
46. Xue M, Xu W, Ou YN, et al. Diabetes mellitus and risks of cognitive impairment and dementia: a systematic review and meta-analysis of 144 prospective studies. Ageing Res Rev, 2019, 55: 100944.
47. Nagai M, Dote K, F?rster CY. Is unrecognized cognitive impairment in hypertension unmasked by diabetes mellitus. Hypertens Res, 2022, 45(6): 1082-1084.
48. Biessels GJ, Despa F. Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol, 2018, 14(10): 591-604.
49. Dai L, Zou L, Meng L, et al. Cholesterol metabolism in neurodegenerative diseases: molecular mechanisms and therapeutic targets. Mol Neurobiol, 2021, 58(5): 2183-2201.
50. Bailey TG, Klein T, Meneses AL, et al. Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment. Eur J Appl Physiol, 2022, 122(8): 1843-1856.
51. Yew B, Nation DA. Cerebrovascular resistance: effects on cognitive decline, cortical atrophy, and progression to dementia. Brain, 2017, 140(7): 1987-2001.
52. Seitz KI, Ehler N, Schmitz M, et al. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: association with childhood trauma. Br J Clin Psychol, 2022, 61(3): 680-700.
53. Alves de Araujo Junior D, Sair HI, Peters ME, et al. The association between post-traumatic stress disorder (PTSD) and cognitive impairment: a systematic review of neuroimaging findings. J Psychiatr Res, 2023, 164: 259-269.
54. Zhou TL, Kroon AA, van Sloten TT, et al. Greater blood pressure variability is associated with lower cognitive performance. Hypertension, 2019, 73(4): 803-811.
55. Novak V, Hajjar I. The relationship between blood pressure and cognitive function. Nat Rev Cardiol, 2010, 7(12): 686-698.
56. Hughes D, Judge C, Murphy R, et al. Association of blood pressure lowering with incident dementia or cognitive impairment: a systematic review and meta-analysis. JAMA, 2020, 323(19): 1934-1944.
57. Gouveia F, Camins A, Ettcheto M, et al. Targeting brain renin-angiotensin system for the prevention and treatment of Alzheimer's disease: past, present and future. Ageing Res Rev, 2022, 77: 101612.
58. Rawle MJ, Cooper R, Kuh D, et al. Associations between polypharmacy and cognitive and physical capability: a British birth cohort study. J Am Geriatr Soc, 2018, 66(5): 916-923.
59. Mancia G, Hall J E. Introduction to a compendium on the pathophysiology and treatment of hypertension. Circ Res, 2019, 124(7): 967-968.
60. Xia H, Du X, Yin G, et al. Effects of smoking on cognition and BDNF levels in a male Chinese population: relationship with BDNF Val66Met polymorphism. Sci Rep, 2019, 9(1): 217.

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