■卒中后认知障碍(PSCI)是一种严重的卒中后并发症,认知后果较差。中风后的血管后果是PSCI的发生和进展可能与血压(BP)密切相关。因此,我们对文献进行了系统回顾和荟萃分析,以检验BP和PSCI之间的相关性.
■我们系统地查询了数据库,包括PubMed,Cochrane图书馆,Embase,还有Scopus,并对报告与BP和PSCI之间关联的比值比(ORs)的研究进行了荟萃分析。两位作者自主评估所有标题,摘要,以及全文和提取的数据遵循流行病学指南中观察性研究的荟萃分析。使用改良的纽卡斯尔-渥太华量表评估研究的质量。
■荟萃分析纳入了12篇文章,包括21,732名受试者的累积参与者队列。在五项研究中,质量评估显示良好,在一项研究中公平,可怜的六个。通过荟萃分析,我们发现高血压,收缩压或舒张压(SBP或DBP)与PSCI显着相关(OR1.53,95%置信区间(CI),1.18-1.99;p=0.001,I2=66%;OR1.13,95%CI,1.05-1.23;p=0.002,I2=52%;OR1.38,95%CI,1.11-1.72;p=0.004,I2=90%,分别)。在亚组分析中,SBP<120mmHg,120-139mmHg,140-159mmHg,160-179mmHg,DBP≥100mmHg高度预测了PSCI的发生(OR1.15,p=0.0003;OR1.26,p=0.010;OR1.15,p=0.05;OR1.02,p=0.009;OR1.96,p<0.00001)。然而,当SBP≥180mmHg和DBP≤99mmHg时,BP对PSCI的预测作用下降(p>0.05)。统计异质性中等到高,在PSCI的SBP中检测到发表偏倚。
■考虑到PSCI的多因素病因,很难得出结论BP是PSCI的独立危险因素。鉴于纳入研究的限制,在解释本荟萃分析的结果时,建议谨慎。具有大量样本量的后续调查对于探索BP作为解决PSCI的预期目标至关重要。
■来自PROSPERO的CRD42023437783。
UNASSIGNED: Post-stroke cognitive impairment (PSCI) represents a serious post-stroke complication with poor cognitive consequences. A vascular consequence after a stroke is that the occurrence and progression of PSCI may be closely related to blood pressure (BP). Thus, we systematically reviewed and performed a meta-analysis of the literature to examine the correlations between BP and PSCI.
UNASSIGNED: We systematically queried databases, including PubMed, the Cochrane Library, Embase, and Scopus, and conducted meta-analyses on studies reporting odds ratios (ORs) related to the association between BP and PSCI. Two authors autonomously assessed all titles, abstracts, and full texts and extracted data following the Meta-Analysis of Observational Studies in Epidemiology guidelines. The quality of the studies was evaluated using the modified Newcastle-Ottawa scale.
UNASSIGNED: Meta-analyses incorporated 12 articles comprising a cumulative participant cohort of 21,732 individuals. The quality assessment indicated good in five studies, fair in one study, and poor in six. Through meta-analyses, we found that hypertension, systolic or diastolic BP (SBP or DBP) was significantly associated with PSCI (OR 1.53, 95% confidence interval (CI), 1.18-1.99; p = 0.001, I 2 = 66%; OR 1.13, 95% CI, 1.05-1.23; p = 0.002, I 2 = 52%; OR 1.38, 95% CI, 1.11-1.72; p = 0.004, I 2 = 90%, respectively). In the subgroup analysis, SBP < 120 mmHg, 120-139 mmHg, 140-159 mmHg, 160-179 mmHg, and DBP ≥ 100 mmHg highly predicted the occurrence of PSCI (OR 1.15, p = 0.0003; OR 1.26, p = 0.010; OR 1.15, p = 0.05; OR 1.02, p = 0.009; OR 1.96, p < 0.00001, respectively). However, the predictive effect of BP for PSCI declines when SBP ≥ 180 mmHg and DBP ≤ 99 mmHg (p > 0.05). Statistical heterogeneity was moderate to high, and publication bias was detected in SBP for PSCI.
UNASSIGNED: Considering the multifactorial etiology of PSCI, it is difficult to conclude that BP is an independent risk factor for PSCI. Given the restricted inclusion of studies, caution is advised when interpreting the findings from this meta-analysis. Subsequent investigations with substantial sample sizes are essential to exploring BP as a prospective target for addressing PSCI.
UNASSIGNED: CRD42023437783 from PROSPERO.