TY - JOUR
T1 - Ambulatory blood pressure monitoring in older people with dementia
T2 - a systematic review of tolerability
AU - Conroy, Simon Paul
AU - Harrison, Jennifer K
AU - Van Der Wardt, Veronika
AU - Harwood, Rowan
AU - Logan, Pip
AU - Welsh, Tomas
AU - Gladman, John R F
N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
PY - 2016/7
Y1 - 2016/7
N2 - 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.
AB - 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.
KW - Aged
KW - Aged, 80 and over
KW - Blood Pressure
KW - Blood Pressure Monitoring, Ambulatory
KW - Dementia/diagnosis
KW - Humans
KW - Hypertension/diagnosis
KW - Predictive Value of Tests
KW - Reproducibility of Results
KW - Severity of Illness Index
U2 - 10.1093/ageing/afw050
DO - 10.1093/ageing/afw050
M3 - Review article (Academic Journal)
C2 - 27055877
VL - 45
SP - 456
EP - 462
JO - Age and Ageing
JF - Age and Ageing
SN - 0002-0729
IS - 4
ER -