{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:27:30Z","timestamp":1792672050231,"version":"4.5.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Obesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is correlated with longitudinal cognitive performance in hypertensive adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The analysis included 16\u00a0791 patients in the\n                      <jats:styled-content style=\"fixed-case\">CSPPT<\/jats:styled-content>\n                      who received at least 2 cognitive assessments by the Mini\u2010Mental State Examination (\n                      <jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>\n                      ) during the follow\u2010up (median, 4.5 years; interquartile range, 4.2\u20134.8 years). Outcomes included changes in\n                      <jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>\n                      scores and cognitive impairment (defined as\n                      <jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>\n                      score less than education\u2010specific cutoff point). A\u00a0marked reduction in\n                      <jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>\n                      scores at the final (compared with at the 1\u2010year) follow\u2010up was apparent in both men (n=4838; mean [\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ] score, 0.41 [3.62]) and women (n=7190; mean [SD] score, 1.07 [4.61]; both\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Analysis using a mixed\u2010effects model revealed an association between higher body mass index with less\n                      <jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>\n                      decline, even after controlling for demographics and comorbidities (men, \u03b2=0.0134 [\n                      <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>\n                      , 0.0036]; women, \u03b2=0.0133 [SE, 0.0034]; both\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). A total of 1037 men (15.3%) and 3317 women (33.1%) developed cognitive impairment. In multivariable Cox regression analyses, being obese in men (11.3% versus 18.0%; hazard ratio, 0.75; 95% confidence interval, 0.60\u20130.94) and women (30.1% versus 36.5%; hazard ratio, 0.82; 95% confidence interval, 0.74\u20130.91) was a protective factor against cognitive impairment compared with normal body mass index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher adiposity is independently associated with slower cognitive decline in Chinese hypertensive adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier:\n                      <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n                      00794885\n                      <jats:styled-content style=\"fixed-case\">CSPPT<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.117.005561","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T20:10:58Z","timestamp":1507666258000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial"],"prefix":"10.1161","volume":"6","author":[{"given":"Jun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China"},{"name":"Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genfu","family":"Tang","sequence":"additional","affiliation":[{"name":"Institute for Biomedicine, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiqun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Affiliated Foshan Hospital of Sun Yat\u2010sen University, Foshan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute for Biomedicine, Anhui Medical University, Hefei, China"},{"name":"National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingli","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First People's Hospital of Lianyungang, Lianyungang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China"},{"name":"Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuli","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China"},{"name":"Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengguo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Affiliated Foshan Hospital of Sun Yat\u2010sen University, Foshan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Peking University First Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiping","family":"Xu","sequence":"additional","affiliation":[{"name":"Institute for Biomedicine, Anhui Medical University, Hefei, China"},{"name":"National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China"},{"name":"Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_6_2_2","unstructured":"WHO . 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