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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.

Authors

Simon P. Conroy

Jennifer K. Harrison

Rowan H. Harwood

PIP LOGAN pip.logan@nottingham.ac.uk
Professor of Rehabilitation Research

Tomas Welsh

John R.F. Gladman



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.

Citation

Conroy, S. P., Harrison, J. K., van der Wardt, V., Harwood, R. H., Logan, P., Welsh, T., & Gladman, J. R. (2016). Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability. Age and Ageing, 45(4), 456-462. https://doi.org/10.1093/ageing/afw050

Journal Article Type Article
Acceptance Date Dec 23, 2015
Online Publication Date Apr 7, 2016
Publication Date Apr 7, 2016
Deposit Date Jan 30, 2017
Publicly Available Date Mar 29, 2024
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 45
Issue 4
Pages 456-462
DOI https://doi.org/10.1093/ageing/afw050
Keywords Hypertension, Dementia, Ambulatory blood pressure monitoring, Older people
Public URL https://nottingham-repository.worktribe.com/output/786031
Publisher URL https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afw050
Additional Information Dr Mohammed Temor Khan as part of his ACF project

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