Elderly hypertension combined with cognitive impairment has been one of the global public health problems. A systematic evaluation of the prevalence of mild cognitive impairment (MCI) in elderly hypertension patients in China helps provide data support for the prevention and treatment of cognitive impairment in elderly hypertension patients.

To analyze the prevalence rate of MCI in elderly hypertensive patients in China by meta-analysis, and further explore the development trend of the prevalence rate.

Chinese and English databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Embase and Web of Science were systematically searched from self-built database to February 22, 2024. NoteExpress software was used for literature management and screening, and the American Institute for Agency for Healthcare Research and Quality (AHRQ) cross-section research evaluation criteria was used for literature quality evaluation. Meta-analysis and subgroup analysis were performed by StataMP 14.0 software.

Twenty-seven cross-sectional studies from 2008 to 2023 were systematically analyzed, involving 57 461 elderly patients with hypertension and 11 812 patients with the disease. A random effects model was used for meta-analysis, and the overall prevalence was 21.3% (95%CI=18.4%-24.2%, P<0.001). A total of 11 provinces/cities/autonomous regions were included in the study, and the prevalence rate varied greatly among provinces/cities/autonomous regions and among geographical regions. The overall prevalence rate showed a fluctuating trend with time from 2008 to 2023. Subgroup analysis showed that the prevalence of MCI was 33.6% (95%CI=6.4%-60.7%, P<0.001) in rural and 21.8% (95%CI=18.1%-25.4%, P<0.001) in urban elderly patients with hypertension. The prevalence in North China (14.0%, 95%CI=9.3%-18.7%, P<0.001) was lower than that in other regions. The prevalence of MMSE+MoCA combined application was 25.9% (95%CI=15.8%-36.0%), and the prevalence of MoCA alone was 21.4% (95%CI=18.5%-24.4%) and MMSE alone was 17.9% (95%CI=13.9%-21.9%) .

The overall prevalence rate of MCI in elderly hypertensive patients in China is high, and there are great differences between different provinces and cities, urban and rural prevalence rate, and the trend of dynamic change with time. The detection rate of MCI varies greatly among different assessment tools, which is affected by the quantity and heterogeneity of literature studies. The conclusion needs to be confirmed by further high-quality studies.

老年高血压合并认知障碍已经成为全球公共卫生问题之一，系统评价我国老年高血压患者轻度认知障碍（MCI）患病率，有助于为防治老年高血压人群的认知损伤提供数据参考。

采用Meta分析的方法评价我国老年高血压患者MCI患病率，并进一步探讨患病率的发展趋势。

系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science中英文数据库，检索时间自建库至2024-02-22，采用NoteExpress软件进行文献管理和筛选，采用美国卫生保健质量和研究机构（AHRQ）横断面研究评价标准进行文献质量评价，由2名研究者独立筛选文献，提取数据并评价纳入文献质量，StataMP 14.0软件进行Meta分析和亚组分析。

系统分析了2008—2023年27篇横断面研究，共涉及老年高血压患者57 461例，其中患MCI 11 812例。通过随机效应模型进行Meta分析，高血压患者MCI总体患病率为21.3%（95%CI=18.4%~24.2%，P<0.001）。纳入研究文献共涉及我国11个省（区、市），各省（区、市）间及地理区域间患病率差异较大；2008—2023年老年高血压MCI患病率随时间呈波动上升趋势，整体患病率均超过10%。亚组分析结果显示：我国农村老年高血压患者MCI患病率为33.6%（95%CI=6.4%~60.7%，P<0.001），城市患者患病率为21.8%（95%CI=18.1%~25.4%，P<0.001）；华北地区患病率（14.0%，95%CI=9.3%~18.7%，P<0.001）较其他地区低。简易精神状态检查量表（MMSE）+蒙特利尔认知评估量表（MoCA）联合应用评估的MCI患病率为25.9%（95%CI=15.8%~36.0%），单一MoCA评估的MCI患病率为21.4%（95%CI=18.5%~24.4%），单一MMSE评估的MCI患病率为17.9%（95%CI=13.9%~21.9%）。

我国老年高血压患者MCI总体患病率较高，不同省市、城乡间患病率存在较大差异，并随时间呈波动上升趋势，不同评估工具的MCI检出率存在一定差异，受文献研究数量和异质性影响，结论尚需进一步高质量研究证实。