背景:高血压患者更有可能出现认知功能下降(CFD)。本研究旨在探讨体力活动水平,睡眠障碍,对高血压患者认知功能下降影响干预效果的工作类型,并建立决策树模型,分析其对高血压患者CFD发生率的预测意义。
方法:这项横断面研究从2022年5月至2022年12月从山东省几家医院招募了原发性高血压患者。受试者排除标准包括诊断为充血性心力衰竭的个体,心脏瓣膜病,心脏手术,肝肾功能障碍,和恶性肿瘤。通过医院医疗和外科门诊等多种渠道进行招聘,wards,和健康体检中心。使用迷你精神状态检查(MMSE)评估认知功能,使用匹兹堡睡眠质量指数(PSQI)评估睡眠质量。此外,我们通过问卷调查获得了有关患者工作类型的信息,并通过国际身体活动问卷(IPAQ)获得了他们的身体活动水平。
结果:逻辑回归分析结果表明,睡眠障碍是高血压患者CFD的重要危险因素(OR:1.85,95CI:[1.16,2.94]),脑力劳动者(OR:0.12,95CI:[0.04,0.37])和同时从事体力劳动者和脑力劳动者(OR:0.5,95CI:[0.29,0.86])对CFD有保护作用。与低强度相比,中度体力活动(OR:0.53,95CI:[0.32,0.87])和高强度体力活动(OR:0.26,95CI:[0.12,0.58])可预防高血压患者的CFD.预测因子在决策树模型中的重要性排名如下:身体活动水平(54%),工作类型(27%),睡眠障碍(19%)。决策树模型预测的ROC曲线下面积为0.72[95%CI:0.68~0.76]。
结论:中度和高强度的体力活动可降低高血压患者发生CFD的风险。睡眠障碍是高血压患者CFD的危险因素。从事脑力劳动和高强度体力活动的高血压患者可有效缓解高血压患者CFD的发作。
Hypertensive patients are likelier to have cognitive function decline (CFD). This study aimed to explore physical activity level, sleep disorders, and type of work that influenced intervention effects on cognitive function decline in hypertensive patients and to establish a decision tree model to analyze their predictive significance on the incidence of CFD in hypertensive patients.
This cross-sectional study recruited patients with essential hypertension from several hospitals in Shandong Province from May 2022 to December 2022. Subject exclusion criteria included individuals diagnosed with congestive heart failure, valvular heart disease, cardiac surgery, hepatic and renal dysfunction, and malignancy. Recruitment is through multiple channels such as hospital medical and surgical outpatient clinics, wards, and health examination centers. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Moreover, we obtained information on the patients\' type of work through a questionnaire and their level of physical activity through the International Physical Activity Questionnaire (IPAQ).
The logistic regression analysis results indicate that sleep disorder is a significant risk factor for CFD in hypertension patients(OR:1.85, 95%CI:[1.16,2.94]), mental workers(OR:0.12, 95%CI: [0.04,0.37]) and those who perform both manual and mental workers(OR: 0.5, 95%CI: [0.29,0.86]) exhibit protective effects against CFD. Compared to low-intensity, moderate physical activity(OR: 0.53, 95%CI: [0.32,0.87]) and high-intensity physical activity(OR: 0.26, 95%CI: [0.12,0.58]) protects against CFD in hypertension patients. The importance of predictors in the decision tree model was ranked as follows: physical activity level (54%), type of work (27%), and sleep disorders (19%). The area under the ROC curves the decision tree model predicted was 0.72 [95% CI: 0.68 to 0.76].
Moderate and high-intensity physical activity may reduce the risk of developing CFD in hypertensive patients. Sleep disorders is a risk factor for CFD in hypertensive patients. Hypertensive patients who engage in mental work and high-intensity physical activity effectively mitigate the onset of CFD in hypertensive patients.