Tolerability of ambulatory blood pressure monitoring (ABPM) in cognitively impaired elderly

Nesti, N.; Pieraccioli, Mariachiara; Mossello, Enrico; Sgrilli, F.; Bulgaresi, Matteo; Crescioli, Elena; Biagini, F.; Caleri, Veronica; Tonon, Elisabetta; Cantini, Claudia; Biagini, Carlo; Marchionni, Niccolò; Ungar, Andrea

doi:10.3109/08037051.2014.916064

Cited by 9 publications

(3 citation statements)

References 13 publications

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“…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

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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.

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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

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“…ABPM is low cost and has relatively good patient acceptance and tolerability, also at advanced age and in presence of cognitive impairment. 34 , 35 Moreover, ABPM is very easy to perform in clinical practice and is widely available in both hospital and primary care settings. By contrast, second-line diagnostic testing for syncope, such as tilt testing, is more time-consuming and has limited availability, requiring patients’ referral to a syncope unit.…”

Section: Discussionmentioning

confidence: 99%

Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Rivasi

Groppelli

Brignole

et al. 2022

European Heart Journal

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Aims Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking. The study hypothesis was that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM. Methods and results ABPM data from reflex syncope patients and controls, matched by average 24 h SBP, age, sex, and hypertension were compared. Patients with constitutional hypotension, orthostatic hypotension, and predominant cardioinhibition during carotid sinus massage or prolonged electrocardiogram monitoring or competing causes of syncope were excluded. Daytime and nighttime SBP drops (<110, 100, 90, 80 mmHg) were assessed. Findings were validated in an independent sample. In the derivation sample, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drops <90 mmHg achieved 91% specificity and 32% sensitivity [odds ratio (OR) 4.6, P < 0.001]. Two or more daytime drops <100 mmHg achieved 84% specificity and 40% sensitivity (OR 3.5, P = 0.001). Results were confirmed in the validation sample of 164 syncope patients and 164 controls: one or more daytime SBP drops <90 mmHg achieved 94% specificity and 29% sensitivity (OR 6.2, P < 0.001), while two or more daytime SBP drops <100 mmHg achieved 83% specificity and 35% sensitivity (OR 2.6, P < 0.001) Conclusion SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.

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“…The superior prognostic ability of ABPM values compared with clinical ones in predicting the risk of mortality and cardiovascular events [34] represents a further reason to perform the assessment in conditions where prognostication is particularly challenging, such as complex geriatric patients. Although ABPM assessment is sometimes considered difficult to perform and poorly tolerated in older patients with cognitive impairment, this was found not to be the case for the vast majority of dementia patients in a memory clinic, with the only exception of those with severe behavioral disorders [35]. However, when ABPM is deemed as non-feasible, home BP measurements seem to be a reliable alternative [34].…”

Section: Peculiar Aspects Of Bp Measurementmentioning

confidence: 99%

Hypertension in the Oldest Old, Beyond Guidelines

Mossello

Desideri

Ungar

2017

Cardiac Management in the Frail Elderly Patient and the Oldest Old

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Tolerability of ambulatory blood pressure monitoring (ABPM) in cognitively impaired elderly

Cited by 9 publications

References 13 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

Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Hypertension in the Oldest Old, Beyond Guidelines

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