Background High blood pressure and poor cardiorespiratory fitness are independent risk factors for dementia. However, few studies have examined if combined longitudinal patterns of these modifiable risk factors are associated with dementia risk. Methods In this prospective cohort study, we used data from the population-based Trøndelag Health (HUNT) Study, Norway. We applied group-based multidimensional trajectory modeling to identify age-specific multidimensional trajectories of SBP, DBP, and estimated cardiorespiratory fitness across 3 surveys (HUNT1, 1984–1986 to HUNT3, 2006–2008). Dementia was diagnosed in the HUNT4 70+ substudy in 2017–2019. We used multivariate logistic regression to estimate odds ratios (ORs) and risk differences (RDs) of dementia. Results In total, 7 594 participants (54.9% women) were included, with a mean age of 44.7 (SD 6.3) years at HUNT1. Dementia was diagnosed in 1 062 (14.0%) participants. We identified 2 multidimensional trajectories throughout adulthood within 3 age groups: one with higher systolic blood pressure (SBP) and diastolic blood pressure (DBP), and lower estimated cardiorespiratory fitness (the poorer group), and one with lower SBP and DBP, and higher cardiorespiratory fitness (the better group). After adjustment for sex, apolipoprotein E ε4 status, education, marital status, and diabetes, the better group had consistently lower risk of dementia in all age groups with the lowest OR in the middle-aged group of 0.63 (95% confidence intervals [95% CI]: 0.51, 0.78) with corresponding RD of −0.07 (95% CI: −0.10, −0.04). Conclusions Having a beneficial multidimensional trajectory of SBP, DBP, and cardiorespiratory fitness in adulthood was associated with reduced dementia risk. Aiming for optimal SBP, DBP, and estimated cardiorespiratory fitness throughout adulthood may reduce dementia risk.

中文翻译：

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收缩压、舒张压、心肺健康的纵向模式及其与痴呆风险的关系： HUNT 研究


背景 高血压和心肺功能差是痴呆的独立危险因素。然而，很少有研究检查这些可改变风险因素的组合纵向模式是否与痴呆风险相关。方法 在这项前瞻性队列研究中，我们使用了来自挪威基于人群的 Trøndelag Health （HUNT） 研究的数据。我们应用基于组的多维轨迹模型来识别 3 项调查 （HUNT1， 1984-1986 至 HUNT3， 2006-2008） 中 SBP 、 DBP 和估计心肺健康的年龄特异性多维轨迹。在 4-70 年的 HUNT2017+ 子研究中诊断出痴呆症。我们使用多变量logistic回归来估计痴呆的比值比（odds ratios， ORs）和风险差（risk differences， RDs）。结果 共纳入 7 594 名参与者 （54.9% 为女性），HUNT1 平均年龄为 44.7 （SD 6.3） 岁。1 062 名 （14.0%） 参与者被诊断出患有痴呆症。我们在 3 个年龄组中确定了整个成年期的 2 条多维轨迹： 一个是较高的收缩压 （SBP） 和舒张压 （DBP），较低的估计心肺适能 （较差的组），另一个是较低的 SBP 和 DBP，较高的心肺适能 （较好的组）。在调整性别、载脂蛋白 E ε4 状态、教育程度、婚姻状况和糖尿病后，较好组在所有年龄组中患痴呆的风险始终较低，中年组的 OR 最低，为 0.63 （95% 置信区间 [95% CI]： 0.51， 0.78），相应的 RD 为 -0.07 （95% CI： -0.10， -0.04）。结论 成年期 SBP 、 DBP 和心肺健康的有益多维轨迹与降低痴呆风险相关。 在整个成年期以最佳 SBP、DBP 和估计的心肺健康为目标可能会降低痴呆风险。