Conroy Simon Paul, Harrison Jennifer K, Van Der Wardt Veronika, Harwood Rowan, Logan Pip, Welsh Tomas, Gladman John R F
University of Leicester School of Medicine, Leicester LE1 5WW, UK.
Centre for Cognitive Ageing and Cognitive Epidemiology & The Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, UK.
Age Ageing. 2016 Jul;45(4):456-62. doi: 10.1093/ageing/afw050. Epub 2016 Apr 7.
ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia.
to review the published evidence to determine the tolerability of ABPM in people with dementia.
English language search conducted in MEDLINE and EMBASE, using 'Ambulatory blood pressure' AND 'Dementia' (and associated synonyms) from 1996 to March 2015.
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.
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.
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.
动态血压监测（ABPM）可能有助于高血压的管理，但对于痴呆症患者对其的耐受性知之甚少。
回顾已发表的证据，以确定ABPM在痴呆症患者中的耐受性。
于1996年至2015年3月在MEDLINE和EMBASE中进行英文检索，检索词为“动态血压”和“痴呆症”（及相关同义词）。
被诊断为痴呆症且使用ABPM测量血压的人群。最初的检索采用标题和摘要审查，由两名审查员商定选定的论文纳入。对潜在符合条件的论文进行评估，保留高质量的论文。两名审查员商定提取的数据进行分析。采用荟萃分析合并各研究结果。
在筛选的221篇摘要中，13项研究（6%）符合纳入标准，5项研究数据充足且质量足够，涉及461名参与者，其中大多数患有轻度至中度痴呆症。77.7%（95%CI 62.2 - 93.2%）能够耐受ABPM；与诊室血压的一致性为中度至弱（仅两项研究 - 收缩压系数为0.3 - 0.38，舒张压系数为0.11 - 0.32）。一项研究比较了亲属进行的家庭血压监测或动态血压监测与诊室血压测量，发现一致性较高（κ 0.81）。现有少量证据表明痴呆症程度增加与耐受性降低有关。
轻度至中度痴呆症患者对ABPM耐受性良好，且除诊室血压外还能提供一些额外信息。然而，很少有研究涉及重度痴呆症患者的ABPM情况。
