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February 12, 2014BMC GeriatricsOpen Access

The treatment of hypertension in people with dementia: a systematic review of observational studies

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Population

23,804 total pooled patients with dementia across 13 observational studies. Mean age 82, 65% female.

Design

Systematic_review

Authors

TWTomas WelshAllen Institute for Brain ScienceJGJohn GladmanNottingham University Hospitals NHS TrustAGAdam GordonQueen Mary University of London

Discussion

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Implication

Hypertension management in dementia warrants tailored guidelines; extends systematic prevalence data to inform targeted trials on risk-benefit balance.

Structured PICO

P
Population
23,804 total pooled patients (15,921 with hypertension) with dementia across 13 observational studies. Mean age 82, 65% female.
I
Intervention
Antihypertensive therapy (including diuretics, ACEi/ARBs, calcium channel blockers, and beta-blockers)
O
Outcome
Prevalence of hypertension, its treatment, change in treatment over time, and achievement of blood pressure control

Hypertension is highly prevalent (45%) in people with dementia and is commonly treated (73%), highlighting the need for dementia-specific guidelines for antihypertensive management given their unique risk-benefit profile.

Limitations

  • Studies were carried out almost entirely within North America and Europe
  • Some studies reported whether participants had ever been on an antihypertensive drug rather than current treatment
  • Several studies reported hypertension dichotomously rather than presenting raw blood pressure data

Cite This Study

Welsh et al. (2014) studied this question.

synapsesocial.com/papers/6a992f1d4f4bbec9e275c87fhttps://doi.org/10.1186/1471-2318-14-19

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1National High Blood Pressure Education Program Working Group Report on Hypertension in the Elderly. National High Blood Pressure Education Program Working Group.1994 · 283 citations
  2. 2Associations of Anti-Hypertensive Treatments with Alzheimer's Disease, Vascular Dementia, and Other Dementias2011 · 214 citations
  3. 3Prevention of Stroke by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension1991 · 2,965 citations
  4. 4The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure The JNC 7 Report2003 · 25,570 citations
  5. 5Treatment of Hypertension in Patients 80 Years of Age or Older2008 · 3,115 citations