Home blood pressure measurement in elderly patients with cognitive impairment
| Autor: | Clémence Boully, M.L. Seux, Laure Caillard, Jean-Sébastien Vidal, Matthieu Plichart, Edouard Chaussade, Olivier Hanon |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Assessment and Diagnosis law.invention Randomized controlled trial law Internal Medicine Humans Medicine Blood pressure monitoring Cognitive impairment Aged Aged 80 and over Advanced and Specialized Nursing Measured blood pressure business.industry Blood Pressure Determination Hypertension management General Medicine Blood Pressure Monitoring Ambulatory Self Care Blood pressure Hypertension complications Hypertension Ambulatory Physical therapy Dementia Female Cardiology and Cardiovascular Medicine business White Coat Hypertension |
| Zdroj: | Blood Pressure Monitoring. 18:208-214 |
| ISSN: | 1359-5237 |
| DOI: | 10.1097/mbp.0b013e3283631b45 |
| Popis: | Home blood pressure measurement (HBPM) is recommended by guidelines for hypertension management. However, this method might be difficult to use in elderly individuals with cognitive disorders. Our aim was to assess the agreement and the feasibility of HBPM by a relative as compared with 24-h ambulatory blood pressure monitoring (ABPM) in elderly patients with dementia.Sixty outpatients with dementia aged 75 years and older with office hypertension (≥140/90 mmHg) were subjected successively to HBPM by a trained relative and 24-h ABPM. The order of the two methods was randomized. Current guidelines' thresholds for the diagnosis of hypertension were used.The mean (SD) age of the patients was 80.8 (6.1) years (55% women) and the mean (SD) mini-mental state examination score was 20.1 (6.9). The feasibility of relative-HBPM was very high, with a 97% success rate (defined by ≥12/18 measurements reported). The blood pressure measurements were highly correlated between the two methods (r=0.75 and 0.64 for systolic blood pressure and diastolic blood pressure, respectively; P0.001 for both). The agreement between the methods for the diagnosis of sustained hypertension and white-coat hypertension was excellent (overall agreement, 92%; κ coefficient, 0.81; 95% CI, 0.61-0.93). Similar results were found for daytime-ABPM.In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM. |
| Databáze: | OpenAIRE |
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