Home blood pressure measurement in elderly patients with cognitive impairment

Plichart, Matthieu; Seux, Marie-Laure; Caillard, L.; Chaussade, Edouard; Vidal, Jean‐Sébastien; Boully, Clémence; Hanon, Olivier

doi:10.1097/mbp.0b013e3283631b45

Cited by 13 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a meta-analysis, HBP measurement was reported to better predict cardiovascular mortality and events than office BP measurement [15]. Even in older patients with cognitive impairment, ABP and HBP measurements were feasible with the assistance of medical staff or family members [16][17][18]. However, there are concerns regarding BP control in older patients with hypertension; which these patients have higher rates of white-coat effect, discrepancy between HBP and ABP measurements [19], higher BP variability [20], postural hypotension [21], postprandial hypotension [22] and lower adherence to medication.…”

Section: Discussionmentioning

confidence: 99%

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Toba,

Ishikawa,

Harada

2023

Blood Pressure Monitoring

View full text Add to dashboard Cite

Objectives Automated office blood pressure (AOBP) measurement often requires assistance. Accompanied by an instructional video, AOBP measurement could be performed independently by patients. Design and methods Seventy-five patients with hypertension were enrolled. AOBP was measured three times at 1-min intervals after 5 min of rest by an automated BP measurement device with the assistance of an animated instructional video. The video was designed originally to instruct patients on the way to measure BP appropriately. Perceived stress was evaluated using a questionnaire after the AOBP measurement. Office BP was measured three times using the same device. Home BP measurement was performed on 5 consecutive days. Results The mean age of the patients was 74.5 ± 10.6 years, and 96% were taking antihypertensive drugs. Mean AOBP, office BP and home BP measurements were 135.2 ± 17.2/81.3 ± 11.1, 139.3 ± 16.3/78.6 ± 10.9 and 129.2 ± 16.7/72.7 ± 8.9 mmHg, respectively. Regarding SBP, the mean AOBP was significantly lower than office BP (P = 0.005) and higher than home BP (P = 0.004). The differences in SBP and DBP between AOBP and home BP measurements were significantly related to patients’ perceived stress when performing AOBP measurements (r = 0.289; P = 0.013 and r = 0.328; P = 0.004). In a multivariate analysis, patients’ perceived stress was a significant predictor of the difference between AOBP and home BP (P = 0.013), even after adjusting for age, sex, BMI and mean of AOBP and home BP. Conclusion AOBP values measured with the assistance of an instructional video were between conventional office and home BP measurements. Perceived stress during AOBP measurement was related to the difference in AOBP from home BP.

show abstract

Section: Discussionmentioning

confidence: 99%

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Toba,

Ishikawa,

Harada

2023

Blood Pressure Monitoring

View full text Add to dashboard Cite

show abstract

“…In the present study we investigated the accuracy and the agreement of currently available measurement methods in very old (> 80 years) hypertensive patients admitted in an internal medicine service of a teaching hospital. Data from previous studies suggest that ambulatory blood pressure monitoring and home self-blood pressure measurements are likely to be the most accurate BP assessment strategies for elderly subjects [29, 30].…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Giorno

Heiniger

Balestra

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Background. The reliability of blood pressure (BP) measurement in hospitalized patients is a topic of debate and the therapeutic implication of the routinely collected BP profiles is probably overestimated. When measurements are performed in elderly patients, further potential sources of misinterpretation occur. Methods. We conducted a subanalysis of a previous study including 79 over 80-year-old hypertensive patients, hospitalized in an internal medicine ward. Five modalities of BP evaluations (measurement by physicians and nurses, self-measurement by patients, Finometer® beat-to-beat finger monitoring, and 24h monitoring) were analyzed, considering agreement and accuracy. Results. The mean (SD) age of the patients was 86.9±4.9 years (50% women). Patients’ self-measurements of both systolic and diastolic BP (SBP and DBP) did not differ significantly from daytime 24-hour monitoring (D24hBPM) (mean difference -1.52, SE 1.71; p: ns and -0.58, SE 1.19 mmHg; p: ns). Conversely, SBP and DBP registered by nurses did significantly differ (mean difference -7.34, SE 1.42; p=0.007 and -4.7, SE 1.05 mmHg; p=0.003). SBP and DBP measured by patients also showed the better concordance, with lowest biases, and narrowest limits of agreements (LoA) and for SBP higher Kappa statistic values (bias 1.5, LoA -28.9 to 31.9; κ 0.563 and bias 0.6, LoA -20.4 to 21.5 mmHg; κ 0.412). The patients’ sensitivity and specificity in predicting hypertensive systolic D24hBPM were 84.8% and 69.7%, respectively. Conclusions. In elderly hospitalized patients an alternative to 24hBPM, self-measurements by patients offer the better agreement and reliability in detecting hypertensive values.

show abstract

“…Upon retest, a comparative study found home reliability was as high as r = 0.91 while office test-retest fell between r = 0.6–0.77 [17]. Home readings tend to be significantly lower than office readings [18–20] and correlate more closely with ABP readings [8, 21]. …”

Section: Introductionmentioning

confidence: 99%

“…The utility of home readings is pronounced in older adults who demonstrate higher white-coat hypertension rates and blood pressure variability than younger adults [21, 22]. Over 50% of older outpatients attending their first visit for a cognitive evaluation are estimated to have substantial white coat hypertension [23], which could lead to overestimations of hypertensive severity [18].…”

Section: Introductionmentioning

confidence: 99%

“Do it-yourself”: Home blood pressure as a predictor of traditional and everyday cognition in older adults

Yeung

Thornton

2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundHypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored.MethodsWe examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses. We also employed “everyday cognition” measures that have been found to have higher prognostic utility for real-world functioning than traditional cognitive tasks.ResultsGood to perfect HBP monitoring compliance over seven days was achieved by 88.7% of the participants with superior reliability (ICC≥.96) to office readings. Higher home systolic BP and pulse pressure predicted worse processing speed, executive function, and everyday cognitive function, whereas lower home diastolic BP predicted worse everyday cognition. Office readings were similarly associated with everyday cognitive function but with no other cognitive measures.ConclusionOur findings are the first to validate HBP as a predictor of neuropsychological function in older adults beyond cognitive screening. Differential relationships among blood pressure variables and specific cognitive domains were observed. With proper standardization and training, we demonstrated that HBP can be obtained in a multi-ethnic community-dwelling older adult cohort. Our findings emphasize the importance of employing blood pressure and cognitive measures that are adequately sensitive to detect vascular-related cognitive impairment in a relatively healthy population. Implications regarding proper HBP measurement for hypertension management, cognitive health, and everyday function are discussed.

show abstract

Home blood pressure measurement in elderly patients with cognitive impairment

Abstract: In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM.

Cited by 13 publications

References 31 publications

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

“Do it-yourself”: Home blood pressure as a predictor of traditional and everyday cognition in older adults

Contact Info

Product

Resources

About