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

Conroy, Simon P. and Harrison, Jennifer K. and van der Wardt, Veronika and Harwood, Rowan H. and Logan, Pip and Welsh, Tomas and Gladman, John R.F. (2016) Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability. Age and Ageing, 45 (4). pp. 456-462. ISSN 1468-2834

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Abstract

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.

Item Type: Article
Additional Information: Dr Mohammed Temor Khan as part of his ACF project
Keywords: Hypertension, Dementia, Ambulatory blood pressure monitoring, Older people
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
Identification Number: 10.1093/ageing/afw050
Depositing User: Dziunka, Patricia
Date Deposited: 30 Jan 2017 11:31
Last Modified: 14 Apr 2017 23:16
URI: http://eprints.nottingham.ac.uk/id/eprint/40005

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