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|Title:||Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability|
|Authors:||Conroy, Simon Paul|
Harrison, Jennifer K.
Van Der Wardt, Veronika
Gladman, John R. F.
|Publisher:||Oxford University Press (OUP) on behalf of British Geriatrics Society|
|Citation:||Age & Ageing, 2016, 45 (4), pp. 456-462|
|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.|
|Rights:||Copyright © the authors, 2016. After embargo this version will be an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.|
|Appears in Collections:||Published Articles, Dept. of Health Sciences|
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