Kev Siv Diuretic Koom Tes Nrog Kev Kawm Zoo Thiab Kev Nco Hauv Cov Neeg Laus hauv Kev Kawm GEM Part 2

Kev soj ntsuam tau raug kho rau qhov muaj feem cuam tshuam ntawm lub hnub nyoog, poj niam txiv neej, haiv neeg (categorized li dawb vs. tsis dawb), kev kawm (categorized li<12, =12, > 12 years of education), income (categorized as <$36,000/yr, $36,000–52,500/yr, >$ 52,500 / xyoo) thiab kev coj cwj pwm ntawm kev noj qab haus huv suav nrog kev haus luam yeeb (tsis tau, yav dhau los, tam sim no) thiab haus cawv (ib lub lis piam (tsis tau, yav dhau los,<1 drink/week, ≥1 drink/week, ≥1 drink/day and ≥2 drink/day). 

Kev sib raug zoo ntawm kev haus luam yeeb thiab kev nco yeej ib txwm muaj teeb meem. Ntawm qhov tod tes, qee cov neeg ntseeg tias kev haus luam yeeb cuam tshuam rau lub hlwb ua haujlwm thiab ua rau tsis nco qab; ntawm qhov tod tes, qee cov neeg ntseeg tias kev haus luam yeeb tuaj yeem pab daws kev ntxhov siab thiab kev ntxhov siab rau qee yam, yog li txhim kho kev nco.

Txawm li cas los xij, tsis hais nqe lus twg yog qhov tseeb, peb yuav tsum paub tias kev haus luam yeeb ua rau lub cev hnyav heev. Nicotine uas muaj nyob rau hauv cov luam yeeb tso tawm dopamine nyob rau hauv lub hlwb thiab tseem nkoos lub hauv nruab nrab lub paj hlwb nyob rau hauv lub hlwb, hloov hom thiab ceev ntawm paj hlwb conduction, thiab ua rau tib neeg lub siab xav thiab xav ua qeeb thiab tsis meej pem.

Tsis tas li ntawd, cov co toxins thiab cov khoom tsis zoo hauv cov luam yeeb cuam tshuam ncaj qha rau cov ntshav ncig thiab thauj cov pa oxygen, ntxiv rau kev ua haujlwm thiab kev noj qab haus huv ntawm lub hlwb. Yog li ntawd, kev haus luam yeeb ntev ntev tuaj yeem ua mob rau lub cim xeeb thiab txo tib neeg txoj kev xav thiab kev txawj ntse, yog li peb yuav tsum nyob deb ntawm kev haus luam yeeb thiab nws cov khoom.

Piv nrog rau qhov no, kev siv lub neej zoo thiab noj qab nyob zoo yuav muaj txiaj ntsig zoo rau kev nco thiab lub hlwb ua haujlwm. Piv txwv li, kev tawm dag zog lub cev ntau dua tuaj yeem txhawb cov ntshav ncig thiab cov metabolism, thiab thaum lub cev qoj ib ce, nws tseem ua rau lub hlwb kev txawj ntse thiab kev tswj muaj peev xwm, uas pab txhim kho kev nco thiab kev xav muaj peev xwm. Tsis tas li ntawd, kev noj zaub mov thiab kev pw tsaug zog zoo kuj tseem yuav cuam tshuam rau lub cev thiab lub hlwb. Tsuas yog raws li kev pw tsaug zog txaus thiab noj zaub mov zoo tuaj yeem ua rau peb muaj lub cev thiab lub hlwb zoo dua.

Hauv cov ntsiab lus, kev sib raug zoo ntawm kev haus luam yeeb thiab kev nco tsis zoo. Yog tias peb xav kom muaj lub hlwb noj qab haus huv thiab muaj peev xwm kawm tau zoo, peb yuav tsum tso tseg kev haus luam yeeb uas muaj nicotine thiab xaiv txoj kev ua neej uas tuaj yeem cuam tshuam kev nco thiab lub hlwb ua haujlwm, xws li kev tawm dag zog, pw tsaug zog zoo, noj zaub mov kom zoo, thiab sib cuam tshuam nrog lwm tus. . Nws tuaj yeem pom tau tias peb yuav tsum txhim kho kev nco, thiab Cistanche tuaj yeem txhim kho kev nco zoo vim Cistanche tuaj yeem tswj hwm qhov sib npaug ntawm cov neurotransmitters, xws li nce qib ntawm acetylcholine thiab kev loj hlob yam, uas tseem ceeb heev rau kev nco thiab kev kawm. Tsis tas li ntawd, Cistanche tseem tuaj yeem txhim kho cov ntshav khiav thiab txhawb nqa cov pa oxygen, uas tuaj yeem ua kom lub hlwb tau txais cov khoom noj txaus thiab lub zog, yog li txhim kho lub hlwb tseem ceeb thiab kev ua siab ntev.

Nyem paub cov tshuaj ntxiv los txhawb kev nco

Cov tshuaj ntsuam xyuas kuj tau hloov kho ib tus zuj zus rau comorbidities xws li keeb kwm ntawm ntshav siab (HTN), keeb kwm ntawm mob stroke (CVA) lossis kev mob ischemic nres (TIA), keeb kwm ntawm ntshav qab zib mellitus (DM), keeb kwm ntawm lub plawv tsis ua hauj lwm (CHF), keeb kwm ntawm kab mob plawv. (CAD), keeb kwm ntawm kab mob raum ( ntsuas los ntawm cov ntshav creatinine, mg / dL), kev nyuaj siab ( ntsuas los ntawm kev siv CES-D), Lub Cev Qhov Ntsuas (BMI, Lub Cev Loj Index (kg / m2), thiab meanystolic (SBP, mmHg). thiab diastolic ntshav siab (DBP, mmHg).

3. Cov txiaj ntsig

3.1. Cov neeg koom nrog

Qhov nruab nrab hnub nyoog ntawm 2707 tus neeg koom yog 78.6 xyoo, 55% yog txiv neej, 96% yog neeg dawb thiab 64% tau kawm ntawv qib siab. 36% qhia tias kub siab, thiab txhais tau tias systolic (SD) thiab cov ntshav siab diastolic yog 135.32 (3.89) thiab 69.09 (0.9) mmHg, feem.

Feem ntau ntawm ntshav qab zib mellitus (DM), kab mob coronary artery (CAD), congestive heartfailure (CHF), thiab cerebrovascular raug mob (CVA) yog 8%, 18%, 1%, thiab 3%, feem (Table 1).

Lub hauv paus txhais tau tias (SD) 3MS, CVLT-FRS thiab FRL cov qhab nia, thiab TMT Part A thiab Part B lub sij hawm (sec) tau qhia txog cov qauv ua haujlwm siab (Table 2). Ntawm 2707 tus neeg koom nrog hauv kev tshuaj ntsuam, 53% tshaj tawm siv tshuaj tiv thaiv hypertensive.

Tshwj xeeb, 17% tau tshaj tawm cov tshuaj diuretic, 11% ACE-I, 2% AT2RB, thiab 21% lwm yam kev siv tshuaj tiv thaiv ntshav siab. Diuretic thiab AT2RB cov neeg siv feem ntau yog cov poj niam, thaum ACE-I thiab lwm cov neeg siv tshuaj tiv thaiv kab mob yog cov txiv neej feem ntau.

Diuretic, ACE-I, AT2RB, thiab lwm cov neeg siv tshuaj tiv thaiv kab mob ntshav siab tau muaj ntau dua ntawm HTN, CAD, TIA, thiab CVA, thaum ACE-I thiab cov neeg siv diuretic muaj ntau dua ntawm CHF thiab lub raum tsis ua haujlwm, thiab ACE-I thiab AT2RB. muaj ntau dua ntawm DM thaum piv rau pawg tsis yog tshuaj.

Txhua tus neeg siv tshuaj tiv thaiv kab mob siab, suav nrog lwm cov tshuaj tiv thaiv kev mob ntshav siab, diuretics, ACE-I, thiab AT2RB cov neeg siv, muaj SBP ntau dua piv rau cov tshuaj tsis yog tshuaj (Table 1).

Tsis muaj qhov sib txawv tseem ceeb hauv cov yam ntxwv hauv qab ntawm BC (N=207) thiab BNC ACE-I cov neeg siv (N=102) lossis nruab nrab ntawm cov poov tshuaj-sparing (N=192) thiab tsis-potassium-sparing Cov neeg siv cov tshuaj diuretics (N=267) (cov ntaub ntawv tsis qhia). Tsis muaj qhov sib txawv tseem ceeb hauv kev paub txog kev ua haujlwm ntawm cov pab pawg tswj thiab ACE-I thiab AT2RB (Table 2).

3.2. Diuretic, ACE-I, thiab AT2RB Siv thiab Kev Paub Txog Kev Ua Haujlwm

Hauv kev txheeb xyuas kev sib txawv ntawm ntau yam, peb pom tias lwm cov tshuaj tiv thaiv kab mob siab thiab cov tshuaj tsis yog tshuaj tsis sib txawv hauv kev paub txog kev soj ntsuam, 3MS, TMT-A, TMT-B, CVLT-FSR, CVLT-FLR, CVLT-Sum, RO-IR, RO -DR, RO-Copy (3MSE: =−.007, SE=.25, P=0.76;TMT-A: =−.007, SE =.87, P=0.77 TMT-B: =−.035, SE=2.3, P=0.13; FSR: =−.005, SE=.17, P=0.82; CVLT-FLR: =−.019, SE=.17; , P=0.43; CVLT-Sum: =-.020, SE=.54, P=0.40; −.033, SE=.23, P=0.18; RO-DR: =−.014, SE=.23, P=0 .57; ROCOPY: =−.017, SE=.15, P=0.48).Kev siv tshuaj diuretic cuam tshuam nrog kev kawm lus thiab kev nco zoo (CVLT-FRS, CVLTFRL thiab CVLT-Sum) piv rau pawg tsis yog tshuaj (=.048, SE=.18, P=0.05; =.048,SE{{83 }}.18, P =0.05; =.057, SE=.57, P =0.02, ntsig txog) thiab lwm pawg tshuaj tiv thaiv ntshav siab ( {{93 }}.053, SE=.21, P=0.1; =.076, SE=.21P =0.02; =.104, SE=.64, P<0.001, respectively) (Table 3). 

Tom qab ntawd peb tau faib cov kev siv diuretic raws li kev siv lub voj orthiazide diuretics thiab peb pom tsis muaj kev koom tes ntawm lub voj lossis thiazide diuretics thiab kev paub txog kev ua haujlwm.

Txawm li cas los xij, thaum diuretics tau stratified raws li kev siv cov poov tshuaj-sparing (Ksparing) thiab tsis-potassium-sparing (KNsparing), peb pom tias potassium-sparing diuretics yog lub luag haujlwm rau kev ua tau zoo ntawm kev kawm lus thiab kev nco (CVLT-FRS, CVLT-FRL, thiab CVLT-Sum) thaum piv rau pawg tsis yog tshuaj ( =.068, SE=.25, P =0.01; =.094, SE{{ 16}}.25, ib<0.001; β=.067, SE=.81, P =0.01, respectively) and another antihypertensive drug group (β=.080, SE=.28, P=0.03; β=.153, SE=. 28, P<0.001; β=.126, SE=.85, P <0.001, respectively) (Table 3). 

Hauv qhov sib piv, peb pom tsis muaj qhov sib txawv ntawm ib qho ntawm 6 qhov kev paub zoo ntawm cov neeg tau txais ACE-Is thiab AT2RBs thiab cov uas tsis tau txais ACE-Is thiab AT2RBs thaum piv rau cov tshuaj tsis yog tshuaj lossis lwm pawg tshuaj tiv thaiv ntshav siab (Table 4). Stratification ntawm ACE-Yog raws li cov ntshav-hlwb barrier permeability tsis cuam tshuam nrog kev paub zoo dua (Table 4).

4. Kev sib tham

Hauv qhov no, kev tshawb fawb hla ntu ntawm cov tsis muaj demented, cov neeg laus hauv zej zog cov neeg tuaj koom ntawm GEMS kev sim tshuaj ntsuam xyuas, peb tau soj ntsuam cov koom haum ntawm kev siv cov tshuaj diuretics, ACE-I, thiab AT2RBon cov ntsiab lus tseem ceeb ntawm kev paub, suav nrog psychomotor ceev, kev ua haujlwm, kev hais lus. , thiab nco, thiab visuospatial muaj nuj nqi.

Peb pom tau hais tias kev siv cov poov tshuaj-sparingdiuretic tau xaiv nrog kev ua tau zoo ntawm kev hais lus thiab kev nco, piv rau lwm tus thiab tsis muaj cov neeg siv tshuaj tiv thaiv.

Txawm hais tias kev soj ntsuam kev sib koom ua ke yog qhov me me, lawv muaj qhov tseem ceeb thiab xaiv.

Qee qhov kev sim tshuaj tau pom tias muaj kev tiv thaiv ntawm diuretics (2) thiab ACE-Is [3, 29], thaum lwm tus tsis pom qhov cuam tshuam ntawm ACE-Is [2, 4, 10, 30], thiazide diuretics [4, 31, 32], lossis AT2RBs [7, 10, 11]. Cov kev tshawb fawb no muaj qhov tsis muaj zog hauv ob txoj hauv kev tseem ceeb.

Ua ntej, lawv tsis tuaj yeem hais qhia txog hom tshuaj tiv thaiv hypertensive. Qhov thib ob, kev paub txog kev ua haujlwm feem ntau yog qhov kawg thib ob, ntsuas siv cov cuab yeej tsis pom kev tsim los tshuaj xyuas kev paub tsis meej. Ntawm no, peb tau txuas ntxiv peb txoj haujlwm ua ntej rau cov neeg laus hauv zej zog uas peb tau pom tias cov tshuaj diuretic thiab ACE-Kuv siv rau ntau tshaj 3 xyoos yog xaiv los ntawm kev txo qis ntawm kev puas tsuaj hauv kev nco thiab kev ua haujlwm [13].

Lwm cov kev tshawb fawb yav tom ntej kuj tau qhia txog kev tiv thaiv cov txiaj ntsig ntawm potassium-sparing diuretics ntawm kev loj hlob ntawm AD [20] thiab hauv ntiaj teb kev paub txog kev poob qis hauv cov ntsiab lus nrog AD [19].

Hauv txoj kev tshawb no, kev siv cov tshuaj potassium-sparing diuretics tau cuam tshuam nrog kev hais lus zoo dua thiab kev nco, thaum piv rau tsis muaj cov neeg siv tshuaj tiv thaiv hypertensive, tab sis kuj thaum piv rau lwm cov neeg siv tshuaj tiv thaiv hypertensive.

Ob pawg tswj hwm muaj qhov sib xws (lwm pab pawg tshuaj tiv thaiv kab mob ntshav siab) lossis qis dua (tsis muaj cov tshuaj tiv thaiv hypertensive) systolic ntshav siab dua li cov neeg siv diuretic, uas qhia txog cov tshuaj tshwj xeeb tshaj li qhov tshwm sim los ntawm kev txo cov ntshav siab.

Tsis muaj qhov sib txawv ntawm cov neeg siv thiazide los yog voj diuretic, qhia tias cov koom haum tiv thaiv cov tshuaj potassium-sparing diuretics tuaj yeem tshwm sim los ntawm cov poov tshuaj ntau ntxiv.Potassium txo qis ntshav siab [33] los ntawm cov nyhuv vasodilator [34, 35], txawm li cas los xij, tseem muaj pov thawj. tias cov poov tshuaj tuaj yeem txo cov ntshav siab, los ntawm kev txo qis oxidative stressor o [36, 37], ob qho tib si tuaj yeem ua kom cov txheej txheem cuam tshuam nrog cov kab mob inneurodegenerative, xws li AD (38, 39) thiab lwm yam kab mob uas muaj hnub nyoog [40, 41]).

Ib txoj kev tshawb fawb yav tom ntej tau pom tias muaj kev sib raug zoo ntawm cov qib qis hauv nruab nrab ntawm cov poov tshuaj thiab cov kua dej hauv lub cev qis ntawm amyloid-beta (A 42), ib qho cim rau AD uas tsis muaj ntshav siab [42].

Cov kev tshawb pom no ua ke nrog peb cov neeg laus uas tsis muaj qhov tsis txaus ntseeg qhia txog kev koom tes ntawm cov ntshav ntshav qis hauv cov txheej txheem neurodegenerative ntawm AD. Ib qho tsis muaj zog ntawm peb txoj kev tshawb fawb yog tias cov ntshav cov ntshav tsis muaj peev xwm, los ntsuas nws txoj kev koom tes nrog kev txawj ntse. Peb qhov kev tshawb pom kuj tuaj yeem yog vim tias ntau tus poj niam tau siv cov tshuaj diuretics.

Txawm li cas los xij, txij li 60% ntawm cov poov tshuaj-sparing thiab tseem 60% ntawm cov neeg siv cov tshuaj uas tsis yog-potassium-sparing diuretic yog cov poj niam, poj niam txiv neej tsis tuaj yeem piav qhia txog cov kev sib raug zoo ntawm kev kawm thiab kev nco txog cov tshuaj potassium-sparing diuretics. Qhia txog kev siv ACE-Is thiab AT2RBs tsis cuam tshuam nrog kev paub zoo dua. functions lees paub qhov kev pom tsis zoo yav dhau los hauv kev sim tshuaj ntsuam xyuas randomized [2, 4, 5, 7, 9–11].

Txawm li cas los xij, cov txiaj ntsig no yog qhov sib piv nrog peb txoj kev tshawb fawb yav dhau los uas ACE-Iuse rau ntau dua 3 xyoos tau cuam tshuam nrog kev txo qis ntawm kev paub tsis meej [13] thiab lwm txoj kev tshawb fawb uas ua haujlwm hauv nruab nrab ACE-Yog qeeb qeeb ntawm lub ntiaj teb kev paub txog kev ua haujlwm [ 21].

Cov txiaj ntsig tsis sib haum xeeb no tuaj yeem piav qhia los ntawm qhov tseeb tias kev sib koom ua ke zoo hauv ob qho kev tshawb fawb tau pom zoo rau kev siv ACE-Is, uas peb tau pom zoo rau kev ntes hauv qhov kev tshawb nrhiav ntu ntu no, thiab tib yam tuaj yeem muaj tseeb rau AT2RBs.Ntxiv rau qhov me me. Tus naj npawb ntawm AT2RB cov neeg siv yuav tau txwv peb lub peev xwm txhawm rau txheeb xyuas cov koom haum tseem ceeb thiab ua rau muaj qhov ua yuam kev hom II.

Muaj ntau qhov zoo ntawm txoj kev tshawb no. Ua ntej, peb txoj kev tshawb fawb suav nrog cov pab pawg loj, muaj txiaj ntsig zoo ntawm cov neeg tuaj yeem pab dawb uas tau soj ntsuam ntau yam kom tsis txhob muaj kev cuam tshuam los ntawm kev siv lub roj teeb loj ntawm kev txawj ntse thiab kev ntsuas ntsuas.

Qhov thib ob, kev siv tshuaj tau pom qhov tseeb. Thib peb, peb muaj lub zog txaus los cais cov neeg siv tshuaj diuretic thiab ACE-I los ntawm kev tsis suav nrog cov neeg uas tau tshaj tawm kev siv cov tshuaj no. Txawm li cas los xij, peb tsis tuaj yeem suav txog qhov cuam tshuam ntawm cov ntshav siab ua ntej, xws li qhov hnyav thiab ntev, thiab kev siv tshuaj vim peb tsis paub tias cov neeg koom nrog tau noj dab tsi ua ntej txoj kev tshawb fawb no.

Lub zog ntawm kev tsis suav nrog cov neeg siv tshuaj ntau yam tshuaj tiv thaiv hypertensive los ntawm peb qhov kev tshuaj ntsuam yuav nyob rau tib lub sijhawm yog qhov tsis muaj zog, vim tias ntau tus neeg siv tshuaj tiv thaiv hypertensive tuaj yeem sawv cev rau pawg neeg nyuaj-tswj hypertensive, thiab qhov no yuav tsum tau eluded hauv kev tshawb fawb yav tom ntej.

Plaub, peb tuaj yeem siv ob pawg tswj hwm (tsis muaj cov neeg siv tshuaj tiv thaiv ntshav siab thiab lwm cov neeg siv tshuaj tiv thaiv hypertensive), tso cai rau peb ntsuas cov tshuaj tshwj xeeb, ntawm nws tus kheej los ntawm keeb kwm ntawm ntshav siab lossis kev tswj ntshav siab tam sim no.

Txoj kev tshawb no kuj tseem muaj qee qhov kev txwv, suav nrog nws cov qauv ntu ntu uas ua ntej kev ntsuas kev tiv thaiv. Tsis tas li ntawd, peb cov neeg kawm tau kawm tau zoo thiab muaj kev sib haum xeeb txog haiv neeg, txwv tsis pub nws muaj peev xwm.

Txawm hais tias cov tshuaj tau raug kuaj pom thaum mus ntsib, peb tsis tuaj yeem txiav txim siab ua raws cai thiab tsis muaj ntaub ntawv qhia txog kev siv cov tshuaj no ua ntej. Raws li nyob rau hauv txhua txoj kev tshawb fawb soj ntsuam, peb cov txiaj ntsig kuj tseem tuaj yeem ua rau muaj kev tsis haum xeeb.

Peb nrhiav kev daws teeb meem los ntawm kev hloov kho keeb kwm ntawm HTN, CHF, DM, thiab CAD, tag nrho cov uas cuam tshuam nrog kev paub tsis meej thiab yog cov lus qhia tseem ceeb rau kev siv diuretics, ACE-Is, thiab AT2RBs.

Tsis tas li ntawd, nyob rau hauv ib qho kev soj ntsuam cais, peb tsuas yog suav nrog cov neeg koom nrog keeb kwm ntawm kev mob ntshav siab (N=1098) thiab muaj peev xwm rov ua dua peb qhov kev txheeb xyuas cov hom phiaj tshuaj rau kev tiv thaiv kev tiv thaiv kom tsis txhob poob siab thiab tej zaum yuav ncua kev mus rau dementia. xaus hauv pawg neeg siv cov tshuaj potassium-sparingdiuretic thaum piv rau cov tshuaj uas tsis yog tshuaj (CVLT-FRS, =.21, P =0.09; CVLT-FRL, =.159, P{ {11}}.025; CVLT-Sum, =.160, P=0.02) thiab lwm pawg tshuaj tiv thaiv ntshav siab (CVLT-FRS, =.071, P{{21} }}.09; CVLT-FRL, =.155, P<0.001; CVLT-Sum, β=.102, P=0.01). 

Lwm qhov kev txwv tsis pub muaj sia nyob yog kev tsis ncaj ncees vim cov neeg siv cov tshuaj tiv thaiv kab mob ntshav siab ntau dua yuav tuag vim muaj kev pheej hmoo tuag ntau ntxiv nrog rau ntshav siab; txawm li cas los xij, qhov no tau hais los ntawm kev siv pab pawg tswj hwm ntawm cov neeg siv tshuaj tsis muaj tshuaj uas muaj cov ntshav siab tsawg dua piv rau txhua pawg. .

Tsis tas li ntawd, txij li muaj tus nqi sib txawv ntawm cov poov tshuaj-sparing diuretics thiab AT2RBs piv rau cov tshuaj uas tsis yog-potassium-sparing diuretics thiab ACE-Is, peb tsis tuaj yeem txiav txim tsis muaj kev cuam tshuam loj heev los ntawm kev lag luam kev noj qab haus huv txij li peb pawg tau raws li cov nyiaj tau los xwb.

Hauv cov ntsiab lus, qhov kev tshawb nrhiav ntu ntu no tau pom tias kev siv cov tshuaj potassium-sparing diuretics tau koom nrog kev kawm lus thiab kev nco zoo hauv cov neeg laus uas tsis muaj demented, qhia txog cov txiaj ntsig neuroprotective.

Cov qauv zoo sib xws thiab xaiv ntawm kev sib koom ua ke ntawm kev siv cov tshuaj potassium-sparing diuretic thiab kev nco ua rau kev tshawb nrhiav ntev ntxiv los ntsuas qhov muaj peev xwm tiv thaiv cov tshuaj potassium-sparing diuretics thiab lub luag haujlwm ntawm potassium hauv kev laus ib txwm muaj.

Kev tshawb nrhiav ntxiv yuav tsum tau tsom mus rau qhov sib txawv ntawm cov neeg laus noj qab haus huv hauv kev hais lus thiab kev nco yuav txhais tau rau cov neeg mob siv cov tshuaj potassium-sparing diuretics, los txiav txim siab txog kev kho mob.Longitudinal kev tshawb fawb kuj tseem xav tau los txiav txim siab seb puas muaj cov tshuaj potassium-sparing diuretic siv nrog rau kev txo qis. kev txawj ntse poob raws sij hawm. Qhov no tuaj yeem ua rau kev txhim kho.

Kev lees paub

Ginkgo Kev Ntsuas Kev Ntsuas Kev Nco (GEM) Kev Kawm tau txais kev txhawb nqa los ntawm U01 AT000162 los ntawm National Center forComplementary and Alternative Medicine (NCCAM) thiab Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv, thiab kev txhawb nqa los ntawm National Institute on Aging, National Heart, Lung, thiab Blood Institute, University of Pittsburgh Alzheimer'sDisease Research Center (P50AG05133), Roena Kulynych Center for Memory and Cognition Research, thiab National Institute of Neurological Disorders and Stroke. Dr. Yasar tau txais kev txhawb nqa los ntawm John A.

HartfordFoundation, nyiaj pab los ntawm NCCAM / NIH (1U01AT00016207) thiab NIA / NIH (T32 AG000247).Peb tau txais nuj nqis rau Stephen Straus, MD, tus thawj coj yav dhau los ntawm NCCAM, uas tau sib tw rau kev soj ntsuam kev ua tiav thiab lwm txoj kev kho mob hauv ib qho kev sib tw. Peb zoo siab lees paub qhov kev koom tes ntawm Dr.

Willmar Schwabe GmbH & Co. KG, Karlsruhe, Lub teb chaws Yelemees, rau lawv cov nyiaj pub dawb ntawm G. biloba ntsiav tshuaj thiab cov placebos zoo ib yam, hauv cov pob hlwv, rau txoj kev kawm. Peb kuj ua tsaug rau peb cov neeg ua haujlwm pab dawb, uas nws txoj kev koom tes ncaj ncees rau hauv txoj kev tshawb fawb ntev no ua rau nws ua tau.

Cov ntaub ntawv

1. Inaba S, Iwai M, Furuno M, et al. Kev ua kom tsis tu ncua ntawm renin-angiotensin system impairscognitive muaj nuj nqi hauv renin / angiotensinogen transgenic nas. Ntshav siab. 2009; 53:356–62 [PubMed: 19047580]

2. McCorvey E Jr, Wright JT Jr, Culbert JP, McKenney JM, Proctor JD, Annett MP. Cov nyhuv ntawm hydrochlorothiazide, enalapril, thiab propranolol ntawm lub neej zoo thiab kev txawj ntse thiab lub cev muaj zog ua haujlwm hauv cov neeg mob ntshav siab. Clin Pharm. Xyoo 1993; 12:300–5 : kuv. [Pub Med: 8458181]

3. Tzourio C, Anderson C, Chapman N, et al. Cov txiaj ntsig ntawm kev txo cov ntshav siab nrog perindopril thiab indapamide kev kho mob ntawm dementia thiab kev paub tsis meej hauv cov neeg mob uas muaj kab mob cerebrovascular.Arch Intern Med. 2003; 163: 1069–75. [Pub Med: 12742805]

4. Peters R, Beckett N, Forette F, et al. Cov xwm txheej dementia thiab ntshav siab txo qis hauv cov ntshav siab hauv cov neeg laus heev sim kev paub txog kev ua haujlwm (HYVET-COG): Kev sim ob qhov muag tsis pom kev, tshuaj placebo-tswj. Lancet Neurol. 2008; 7:683-9. [Pub Med: 18614402]

5. Steiner SS, Friedhoff AJ, Wilson BL, Wecker JR, Santo JP. Kev kho mob ntshav siab thiab kev ua neej zoo: Kev sib piv ntawm atenolol, captopril, enalapril, thiab propranolol. J Hum Hypertens. Xyoo 1990; 4:217–25. [Pub Med: 2194029]

6. Frimodt-Moeller J, Poulsen DL, Kornerup HJ, Bech P. Kev ua neej zoo, kev mob tshwm sim thiab kev ua tau zoo ntawm lisinopril piv nrog metoprolol hauv cov neeg mob uas muaj mob me mus rau nruab nrab qhov tseem ceeb kub siab. J HumHypertens. Xyoo 1991; 5:215–21. [Pub Med: 1656040]

7. Lithell H, Hansson L, Skoog I, et al. Txoj kev tshawb fawb txog kev paub txog thiab kev kwv yees hauv cov neeg laus (SCOPE): Cov txiaj ntsig tseem ceeb ntawm qhov kev sim ua ob qhov muag tsis pom kev. J Hypertens. 2003; 21:875–86.[PubMed: 12714861]

8. Zuccala G, Onder G, Marzetti E, et al. Kev siv cov angiotensin-hloov enzyme inhibitors thiab kev hloov pauv hauv kev paub txog kev ua haujlwm ntawm cov neeg mob plawv tsis ua haujlwm. Eur Heart J. 2005; 26:226–33. [Pub Med: 15618043]

9. Fogari R, Mugellini A, Zoppi A, et al. Cov txiaj ntsig ntawm telmisartan / hydrochlorothiazide vs lisinopril / hydrochlorothiazide ua ke ntawm kev mob ntshav siab thiab kev paub txog kev ua haujlwm hauv cov neeg mob ntshav siab. J Hum Hypertens. 2006; 20:177–85. [Pub Med: 16306998]

10. Anderson C, Teo K, Gao P, et al. Renin-angiotensin system blockade thiab kev paub txog kev ua haujlwm hauv cov neeg mob uas muaj kev pheej hmoo siab ntawm kab mob plawv: Kev tshuaj xyuas cov ntaub ntawv los ntawm ONTARGET thiab TRANSCEND cov kev tshawb fawb. Lancet Neurol. 2011; 10:43–53. [Pub Med: 20980201]

11. Diener HC, Sacco RL, Yusuf S, et al. Cov teebmeem ntawm cov tshuaj aspirin ntxiv rau ncua-tso dipyridamole versusclopidogrel thiab telmisartan ntawm kev xiam oob qhab thiab kev paub txog kev ua haujlwm tom qab rov muaj mob stroke hauv cov neeg mob uas muaj ischemic stroke hauv kev tiv thaiv kev tiv thaiv kom tsis txhob mob stroke thib ob (PROFESS) sim: Kev tshawb nrhiav ob qhov muag tsis pom kev, nquag, thiab cov tshuaj placebo-tswj. Lancet Neurol. 2008; 7:875–84. [Pub Med: 18757238]

12. Ohrui T, Tomita N, Sato-Nakagawa T, et al. Cov teebmeem ntawm lub hlwb nkag mus rau ACE inhibitors ntawm Alzheimer tus kab mob kev loj hlob. Neurology. 2004; 63:1324–5. [Pub Med: 15477567]

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