Antihypertensive treatment in people with dementia

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van der Wardt, Veronika and Logan, Phillipa A. and Conroy, Simon and Harwood, Rowan H. and Gladman, John R.F. (2014) Antihypertensive treatment in people with dementia. Journal of the American Medical Directors Association, 15 (9). pp. 620-629. ISSN 1525-8610

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Official URL: http://www.jamda.com/article/S1525-8610%2814%2900141-8/abstract

Abstract

Introduction

The range and magnitude of potential benefits and harms of antihypertensive treatment in people with dementia has not been previously established.

Method

A scoping review to identify potential domains of benefits and harms of antihypertensive therapy in people with dementia was undertaken. Systematic reviews of these domains were undertaken to examine the magnitude of the benefits or harms.

Results

Potential outcome domains identified in the 155 papers in the scoping review were cardio-vascular events, falls, fractures and syncope, depression, orthostatic hypotension, behavioural disturbances, polypharmacy risks, kidney problems, sleep problems, interactions with cholinesterase inhibitors and pain. The systematic reviews across these domains identified relatively few studies done in people with dementia, and no convincing evidence of safety, benefit or harm across any of them.

Discussion

There is no justification for materially different guidance for the treatment of hypertension in people with dementia, but sufficient evidence to warrant particular caution and further research into treatment in this group of patients.

Item Type:

Article

Additional Information:

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of the American Medical Directors Association. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Medical Directors Association, 15(9), (2014), doi: 10.1016/j.jamda.2014.03.005

Keywords:

dementia, Alzheimer's, hypertension, antihypertensive treatment, falls, cardio-vascular events,depression, behavioural problems

Schools/Departments:

University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing

Identification Number:

https://doi.org/10.1016/j.jamda.2014.03.005

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