PDF(Pubmed)
Abstract：
Blood pressure variability (BPV) impacts brain health by influencing brain structure and cerebrovascular pathologies, though the mechanisms are poorly understood. Changes in the cerebrovasculature may lead to late-onset depression, cognitive impairment, and dementia, however the relationship between BPV with depression and anxiety remains unclear, due to methodological differences and inconsistencies in past research. This review aims to clarify the association between BPV with depression and anxiety in adults to inform understandings of the mechanisms implicating BPV in cognitive health. A systematic search from inception through to January 2024 was performed on Embase, PubMed, PsycINFO, and Web of Science. Studies that assessed BPV quantified by beat-to-beat, 24-hour, or visit-to-visit were eligible if the standardised assessment of depression and/or anxiety were reported as a linear association, or mean differences across control and affect groups. A total of 14 articles reporting on 13 samples and N = 5055 persons met the inclusion criteria (median female proportion = 61 %, range 0 % - 76 %). A meta-analysis was not possible due to methodological heterogeneity in BPV measurements and metrics across studies. Mixed results were observed across depression studies with inconsistencies and variation in the direction, strength of association, and BPV metric. There was weak evidence from only three studies to support a linear association between systolic coefficient of variation and anxiety. Collectively, the findings contribute to understanding the association between BPV and brain health, suggesting that any relationship between BPV and brain structures critical for cognitive function are independent of depression and only modestly implicate anxiety.
摘要：
血压变异性（BPV）通过影响大脑结构和脑血管疾病来影响大脑健康，虽然机制知之甚少。脑血管系统的变化可能导致迟发性抑郁症，认知障碍，和痴呆症，然而，BPV与抑郁和焦虑之间的关系尚不清楚，由于过去研究的方法差异和不一致。这篇综述旨在阐明成人BPV与抑郁和焦虑之间的关系，以了解BPV在认知健康中的作用机制。从开始到2024年1月的系统搜索在Embase上进行，PubMed,PsycINFO,和WebofScience。通过逐次跳动来评估BPV的研究，24小时,如果抑郁和/或焦虑的标准化评估报告为线性关联，或访视符合资格，或平均控制组和影响组之间的差异。共有14篇文章报告13个样本，N=5055人符合纳入标准（女性比例中位数=61%，范围0%-76%）。由于研究中BPV测量和指标的方法异质性，无法进行荟萃分析。在抑郁症研究中观察到混合结果，方向不一致和变化，联合的力量,和BPV指标。只有三项研究的证据表明收缩压变异系数与焦虑之间存在线性关系。总的来说，这些发现有助于理解BPV与大脑健康之间的关系，这表明BPV和对认知功能至关重要的大脑结构之间的任何关系都独立于抑郁，并且仅适度地涉及焦虑。
