scholarly journals Diagnostic accuracy of office blood pressure compared to home blood pressure in patients with mild cognitive impairment and dementia

2019 ◽  
Vol 18 (7) ◽  
pp. 637-642 ◽  
Author(s):  
Rianne AA de Heus ◽  
Maxime V Tumelaire ◽  
Marcel GM Olde Rikkert ◽  
Jurgen AHR Claassen
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Office Blood Pressure ◽  
Memory Clinic ◽  
Cross Sectional

Background: Hypertension and cognitive impairment often coexist in older people. Office blood pressure measurement is a poor indicator for diagnosing hypertension in the general population. However, its diagnostic accuracy has not been substantially studied in patients with cognitive impairment. Aim: The aim of this study was to determine the proportion of misdiagnosis of hypertension in patients with mild cognitive impairment and dementia compared to no cognitive impairment, by comparing office blood pressure measurement with home blood pressure measurement. Methods: A cross-sectional study including consecutive patients visiting a memory clinic between 2014 and 2017. Home blood pressure was measured for one week according to the European guidelines. Office blood pressure was assessed during routine clinical practice. Using guideline definitions for normal blood pressure and hypertension, we investigated the proportion of disagreement between office blood pressure measurement and home blood pressure measurement. Univariable and multivariable logistic regression compared disagreement in diagnosis between patients with dementia, mild cognitive impairment and no cognitive impairment. Results: Of 213 patients (aged 73.4±9.0 years, 42% women) 82 had dementia, 65 had mild cognitive impairment and 66 had no cognitive impairment. Mean office blood pressure was 156/84±23/11 mmHg and mean home blood pressure was 139/79±16/10 mmHg. In 31% of patients, there was disagreement in hypertension diagnosis. This proportion was higher for mild cognitive impairment (38.5%) and dementia (35.4%) compared to no cognitive impairment (18.2%), with adjusted odds ratios of 3.7 (95% confidence interval 1.5–9.0), P=0.005 for mild cognitive impairment and 3.4 (1.3–8.6), P=0.011 for dementia. Conclusions: In memory clinic patients with dementia and mild cognitive impairment, the diagnostic accuracy of office blood pressure measurement is lower compared to patients without cognitive impairment. To avoid the risk of making improper treatment decisions in this vulnerable group, a diagnosis of hypertension should be based on home blood pressure measurement, not office blood pressure measurement.

scholarly journals Effects of Blood Pressure on Cognitive Performance in Aging: A Systematic Review

2020 ◽  
Vol 10 (12) ◽  
pp. 919
Author(s):  
Giuseppe Forte ◽  
Maria Casagrande
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Longitudinal Studies ◽  
Cognitive Performance ◽  
High Blood Pressure ◽  
Pressure Measurement ◽  
Healthy Aging ◽  
Blood Pressure Measurement ◽  
Cross Sectional

Introduction: Cognitive functions play a crucial role in daily functioning. Unfortunately, some cognitive abilities decline in the process of healthy aging. An increasing body of evidence has highlighted the role of lifestyle habits and cardiovascular diseases, such as high blood pressure, in increasing the risk of cognitive decline. Surprisingly, although hypertension is a modifiable risk factor for cerebrovascular damage, the role of hypertension on cognitive impairment development is not still clear. Several key questions remain unresolved, and there are many inconsistent results in studies considering this topic. This review is aimed to systematically analyze the results found by the studies that investigated whether high blood pressure, in both hypertensive and healthy people, is related to cognitive performance. Furthermore, it points to evaluate the role of age in this relationship. Method: The review process was conducted according to the PRISMA statement. Restrictions were made, selecting the studies in English and published in peer-review journals, including at least one cognitive measure and blood pressure measurement. Studies that included participants with medical conditions, dementia, psychiatric disorders, strokes, and brain injury were excluded. Cross-sectional and longitudinal studies were analyzed separately. Finally, blood pressure measured at young life (18–39 years), midlife (age 40–64 years), elderly (65–74 years), and old age (≥75 years) were considered. Results: The review allows 68 studies to be selected, which include 154,935 participants. The results provided evidence of an adverse effect of exposure to high blood pressure on cognitive performance. High blood pressure in midlife was linked with poorer cognitive functioning; this evidence was found in cross-sectional and longitudinal studies. However, this association declines with increasing age and tends to become inconsistent. In older people, the relationship between blood pressure and cognitive performance is non-linear, highlighting a beneficial effect of high blood pressure on cognition. Conclusions: Despite some limitations, this review showed that cardiovascular and neuro-cognitive systems do not operate in isolation, but they are related. Blood pressure can be considered an early biomarker of cognitive impairment, and the necessity of early blood pressure measurement and control was underlined.

scholarly journals Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

2018 ◽  
Vol 33 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Sehun Kim ◽  
Jin Joo Park ◽  
Seung-Ah Lee ◽  
Youngjin Cho ◽  
Yeonyee E. Yoon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diagnostic Accuracy ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
Hypertensive Patients

scholarly journals Diagnostic Accuracy of Unattended Automated Office Blood Pressure Measurement in Screening for Hypertension in Kenya

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1490-1498 ◽  
Author(s):  
Anthony O. Etyang ◽  
Antipa Sigilai ◽  
Emily Odipo ◽  
Robinson Oyando ◽  
Gerald Ong’ayo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diagnostic Accuracy ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
Automated Office Blood Pressure

Home Blood Pressure Measurement May Lead to Less Strict Control of Office Blood Pressure

2008 ◽  
Vol 30 (3-4) ◽  
pp. 225-231
Author(s):  
Kimika Eto ◽  
Takuya Tsuchihashi ◽  
Yuko Ohta ◽  
Uran Onaka ◽  
Michio Ueno
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Office Blood Pressure ◽  
Strict Control

Abstract 10357: The Usefulness of Home Blood Pressure Measurement in the Diagnosis of Hypertension: A Prospective Multicenter Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Deuk-Young Nah ◽  
Jin-Wook Chung ◽  
Jun-Ho Bae ◽  
Dong-Seok Lee ◽  
Moo-Yong Rhee
Keyword(s):  
Blood Pressure ◽  
Diagnostic Accuracy ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Predictive Value ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Current Guideline ◽  
Guideline Values ◽  
Diagnosis Of Hypertension

Introduction: The major hypertension guidelines suggest methods for diagnosing hypertension by measuring the 24-hour ambulatory blood pressure (ABP) or home blood pressure (HBP) if hypertension is suspected. Hypothesis: there is no consensus of cut off values for HBP as the criterion for hypertension and also optimal duration of home blood pressure measurement (HBPM). Methods: 319 suspected hypertension patients (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, average value of three times measurements of blood pressure in the office) were included in four university hospital. The blood pressure (BP) measurement taken by patients in his/her home with HBPM device (Watch BP Home, Microlife, Swiss) and measured three times with one minute interval at morning and evening for 7 days. The 24-hour ambulatory blood pressure measurement (ABPM) was performed by Mobil-O-Graph (IEM. GmbH, Germany). The device was set to obtain BP readings at 30-minute intervals during the day and night. The definition of hypertension was as follows, SBP ≥135 mmHg or DBP ≥85 mmHg for HBPM and SBP ≥130 mmHg or DBP ≥85 mmHg for ABPM. For the analysis for diagnostic accuracy of HBPM, we used ABPM as a reference standard for the diagnosis of hypertension. Results: We decided to exclude 53 patients due to dropout or lack of valid BP measurement (valid leadings <70% of tried measurements of ABPM and less than 5-days HBPM). Finally we analyzed BP measurement data of 266 patients. Dropout or invalid BP measurement was more common in ABPM than HBPM. HBP was measured at least 6 days in more than 90% patients and white coat hypertension was diagnosed more frequently in the HBPM. HBPM had a more than 98.6% positive predictive value and 46.8% negative predictive value for the diagnosis of hypertension when put the criteria on ABPM. There are no difference of diagnostic accuracy for the diagnosis of hypertension according to the 5-day, 6-day and 7-day HBPM. Conclusions: A 5-day HBPM is enough for the diagnosis of hypertension considering ABPM as a reference. The cut off value of hypertension in HBPM is same to the current guideline values (135/85 mmHg) in this study. HBPM is an effective and available method for the diagnosis of hypertension in suspected hypertensive patients.

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