2023-03-29 エディンバラ大学
研究は、英国バイオバンク研究やCOGENT、国際血圧コンソーシアムなどから30,000人以上の参加者から収集したMRI画像と遺伝子データを使用し、認知機能に高血圧が与える影響を調べた。研究結果は、治療の精度を高め、最もリスクの高い患者の認知障害の発生を予防するためのより強力な治療法を開発するための基盤となる。
ただし、研究の制限は、英国バイオバンク研究の参加者が主に白人で中年層であるため、高齢者などに結果を拡張することができない可能性があることです。
<関連情報>
- https://www.ed.ac.uk/news/2023/high-blood-pressure-link-to-memory-loss-dementia
- https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehad101/7081391?login=false
遺伝子解析により、血圧上昇に伴う認知障害に関連する脳構造を特定 Genetic analyses identify brain structures related to cognitive impairment associated with elevated blood pressure
Mateusz Siedlinski , Lorenzo Carnevale , Xiaoguang Xu , Daniela Carnevale, Evangelos Evangelou , Mark J Caulfield, Pasquale Maffia, Joanna Wardlaw, Nilesh J Samani, Maciej Tomaszewski,Giuseppe Lembo, Michael V Holmes, Tomasz J Guzik
European Heart Journal Published:27 March 2023
DOI:https://doi.org/10.1093/eurheartj/ehad101
Abstract
Background and aims
Observational studies have linked elevated blood pressure (BP) to impaired cognitive function. However, the functional and structural changes in the brain that mediate the relationship between BP elevation and cognitive impairment remain unknown. Using observational and genetic data from large consortia, this study aimed to identify brain structures potentially associated with BP values and cognitive function.
Methods and results
Data on BP were integrated with 3935 brain magnetic resonance imaging-derived phenotypes (IDPs) and cognitive function defined by fluid intelligence score. Observational analyses were performed in the UK Biobank and a prospective validation cohort. Mendelian randomisation (MR) analyses used genetic data derived from the UK Biobank, International Consortium for Blood Pressure, and COGENT consortium. Mendelian randomisation analysis identified a potentially adverse causal effect of higher systolic BP on cognitive function [-0.044 standard deviation (SD); 95% confidence interval (CI) -0.066, -0.021] with the MR estimate strengthening (-0.087 SD; 95% CI -0.132, -0.042), when further adjusted for diastolic BP. Mendelian randomisation analysis found 242, 168, and 68 IDPs showing significant (false discovery rate P < 0.05) association with systolic BP, diastolic BP, and pulse pressure, respectively. Most of these IDPs were inversely associated with cognitive function in observational analysis in the UK Biobank and showed concordant effects in the validation cohort. Mendelian randomisation analysis identified relationships between cognitive function and the nine of the systolic BP-associated IDPs, including the anterior thalamic radiation, anterior corona radiata, or external capsule.
Conclusion
Complementary MR and observational analyses identify brain structures associated with BP, which may be responsible for the adverse effects of hypertension on cognitive performance.
