| Project/Area Number |
18K07489
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Review Section |
Basic Section 52010:General internal medicine-related
|
|---|
| Research Institution | National Center for Geriatrics and Gerontology |
|---|
Principal Investigator |
Shimizu Atsuya 国立研究開発法人国立長寿医療研究センター, 病院, 部長 (50345914)
|
|---|
| Project Period (FY) |
2018-04-01 – 2024-03-31
|
| Project Status |
Completed (Fiscal Year 2023)
|
| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
|
|---|
| Keywords | 高血圧 / 認知症 / 大脳白質病変 / 高血圧管理 / 認知機能保持 / 高齢者 / フレイル / 左室拡張障害重症 / 血圧 / 左室拡張障害重症度 / 至適血圧 |
|---|
| Outline of Final Research Achievements |
In order to clarify the optimal blood pressure control value for maintaining cognitive function in elderly people, we investigated the relationship between cerebral white matter lesions and blood pressure control status. We evaluated the relationship between the change in cerebral white matter lesion volume (mL/year) and mean systolic blood pressure by ABPM in early-stage elderly people with hypertension. In a unified analysis of all patients, we were unable to confirm a significant association between the two items. On the other hand, when all patients were divided into two groups based on the median cerebral white matter lesion volume at registration (5.6 mL), we found that the increase in cerebral white matter lesion volume was most suppressed in the low white matter lesion group in the region of 110-120 mmHg nighttime systolic blood pressure, and in the high white matter lesion group in the region of 130-140 mmHg nighttime systolic blood pressure.
|
| Academic Significance and Societal Importance of the Research Achievements |
本研究により、高齢者では大脳白質病変量の違いにより血圧管理の目標となる至適血圧が異なること、さらに血圧管理上の基準は夜間収縮期血圧であることを指摘した。従って高齢患者に於ける認知機能低下の進行を抑制することを考えれば、患者ごとに大脳白質病変量を評価し、その重症度に則って血圧の管理目標値をおよそ20mmHg程度高めに保持することが望ましいことを明らかとした。なお夜間収縮期血圧を血圧管理指標とするべき理由は、高齢者では動脈の血圧調節能が衰えつつあり、昼間は活動性が高く血圧そのものも乱高下し易いため、活動性が低く比較的安定し本来の基準血圧を反映したものが夜間血圧であるからと考えられた。
|
