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

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:...

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Main Authors: Conroy, Simon P., Harrison, Jennifer K., van der Wardt, Veronika, Harwood, Rowan H., Logan, Pip, Welsh, Tomas, Gladman, John R.F.
Format: Article
Published: Oxford University Press 2016
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Online Access:https://eprints.nottingham.ac.uk/40005/
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author Conroy, Simon P.
Harrison, Jennifer K.
van der Wardt, Veronika
Harwood, Rowan H.
Logan, Pip
Welsh, Tomas
Gladman, John R.F.
author_facet Conroy, Simon P.
Harrison, Jennifer K.
van der Wardt, Veronika
Harwood, Rowan H.
Logan, Pip
Welsh, Tomas
Gladman, John R.F.
author_sort Conroy, Simon P.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-400052020-05-04T17:47:25Z https://eprints.nottingham.ac.uk/40005/ Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability Conroy, Simon P. Harrison, Jennifer K. van der Wardt, Veronika Harwood, Rowan H. Logan, Pip Welsh, Tomas Gladman, John R.F. 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. Oxford University Press 2016-04-07 Article PeerReviewed Conroy, Simon P., Harrison, Jennifer K., van der Wardt, Veronika, Harwood, Rowan H., Logan, Pip, 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 Hypertension Dementia Ambulatory blood pressure monitoring Older people https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afw050 doi:10.1093/ageing/afw050 doi:10.1093/ageing/afw050
spellingShingle Hypertension
Dementia
Ambulatory blood pressure monitoring
Older people
Conroy, Simon P.
Harrison, Jennifer K.
van der Wardt, Veronika
Harwood, Rowan H.
Logan, Pip
Welsh, Tomas
Gladman, John R.F.
Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title_full Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title_fullStr Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title_full_unstemmed Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title_short Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
title_sort ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability
topic Hypertension
Dementia
Ambulatory blood pressure monitoring
Older people
url https://eprints.nottingham.ac.uk/40005/
https://eprints.nottingham.ac.uk/40005/
https://eprints.nottingham.ac.uk/40005/