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Antihypertensive treatment in people with dementia

van der Wardt, Veronika; Logan, Phillipa A.; Conroy, Simon; Harwood, Rowan H.; Gladman, John R.F.

Authors

Veronika van der Wardt v.vanderwardt@nottingham.ac.uk

Phillipa A. Logan pip.logan@nottingham.ac.uk

Simon Conroy spc3@le.ac.uk

Rowan H. Harwood Rowan.Harwood@nuh.nhs.uk

John R.F. Gladman john.gladman@nottingham.ac.uk



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.

Journal Article Type Article
Publication Date Sep 1, 2014
Journal Journal of the American Medical Directors Association
Print ISSN 1525-8610
Electronic ISSN 1525-8610
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 15
Issue 9
APA6 Citation van der Wardt, V., Logan, P. A., Conroy, S., Harwood, R. H., & Gladman, J. R. (2014). Antihypertensive treatment in people with dementia. Journal of the American Medical Directors Association, 15(9), doi:10.1016/j.jamda.2014.03.005
DOI https://doi.org/10.1016/j.jamda.2014.03.005
Keywords dementia, Alzheimer's, hypertension, antihypertensive treatment, falls, cardio-vascular events,depression, behavioural problems
Publisher URL http://www.jamda.com/article/S1525-8610%2814%2900141-8/abstract
Related Public URLs http://www.sciencedirect.com/science/article/pii/S1525861014001418
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
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

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AHT in dementia repository final draft.pdf (581 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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