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ABPM in older people with dementia R3 6.12.15 no TT.pdf (429.71 kB)

Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability

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posted on 2016-06-10, 13:40 authored by Simon Paul Conroy, Jennifer K. Harrison, Veronika Van Der Wardt, Rowan Harwood, Pip Logan, Tomas Welsh, John R. F. Gladman
Background: ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia. Objective: to review the published evidence to determine the tolerability of ABPM in people with dementia. Methods: English language search conducted in MEDLINE and EMBASE, using ‘Ambulatory blood pressure’ AND ‘Dementia’ (and associated synonyms) from 1996 to March 2015. Inclusion criteria: people diagnosed with dementia AND in whom blood pressure was measured using ABPM. The initial search was undertaken using title and abstract reviews, with selected papers being agreed for inclusion by two reviewers. Potentially eligible papers were assessed, and high-quality papers were retained. Two reviewers agreed the abstracted data for analysis. Meta-analysis was used to combine results across studies. Results: of the 221 screened abstracts, 13 studies (6%) met inclusion criteria, 5 had sufficient data and were of sufficient quality, involving 461 participants, most of whom had mild–moderate dementia. 77.7% (95% CI 62.2–93.2%) were able to tolerate ABPM; agreement with office BP was moderate to weak (two studies only—coefficients 0.3–0.38 for systolic blood pressure and 0.11–0.32 for diastolic blood pressure). One study compared home BP monitoring by a relative or ambulatory BP monitoring with office BP measures and found high agreement (κ 0.81). The little available evidence suggested increased levels of dementia being associated with reduced tolerability. Conclusions: ABPM is well tolerated in people with mild–moderate dementia and provides some additional information over and above office BP alone. However, few studies have addressed ABPM in people with more severe dementia.

History

Citation

Age & Ageing, 2016, 45 (4), pp. 456-462

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

  • AM (Accepted Manuscript)

Published in

Age & Ageing

Publisher

Oxford University Press (OUP) on behalf of British Geriatrics Society

issn

0002-0729

eissn

1468-2834

Acceptance date

2015-12-23

Copyright date

2016

Available date

2017-04-07

Publisher version

http://ageing.oxfordjournals.org/content/45/4/456

Language

en

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