TY - JOUR
T1 - The association between blood pressure variability (BPV) with dementia and cognitive function: a systematic review and meta-analysis protocol
AU - Tully, Phillip J.
AU - Turnbull, Deborah A.
AU - Anstey, Kaarin J.
AU - Beckett, Nigel
AU - Beiser, Alexa S.
AU - Birns, Jonathan
AU - Brickman, Adam M.
AU - Burns, Nicholas R.
AU - Cosh, Suzanne
AU - de Leeuw, Peter W.
AU - Dorstyn, Diana
AU - Elias, Merrill F.
AU - Jukema, J. Wouter
AU - Kario, Kazuomi
AU - Kikuya, Masahiro
AU - Kroon, Abraham A.
AU - Launer, Lenore J.
AU - Mahajan, Rajiv
AU - McGrath, Emer R.
AU - Mooijaart, Simon P.
AU - van Charante, Eric P. Moll
AU - Nagai, Michiaki
AU - Ninomiya, Toshiharu
AU - Ohara, Tomoyuki
AU - Ohkubo, Takayoshi
AU - Oishi, Emi
AU - Peters, Ruth
AU - Richard, Edo
AU - Satoh, Michihiro
AU - Seshadri, Sudha
AU - Stott, David. J.
AU - van Gool, Willem A.
AU - van Middelaar, Tessa
AU - Trompet, Stella
AU - Giles, Kristy
AU - Drioli-Phillips, Phoebe
AU - Aaimir, Umama
AU - Connolly, Frank
AU - Tzourio, Christophe
AU - VARIABLE BRAIN Consortium
PY - 2018/10/15
Y1 - 2018/10/15
N2 - Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population-adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure >= 140 mmHg and/or diastolic blood pressure >= 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure-any metric of BPV (systolic, diastolic or both) over any duration; comparison-persons without dementia who do not have elevated BPV; and outcome-dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.
AB - Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population-adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure >= 140 mmHg and/or diastolic blood pressure >= 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure-any metric of BPV (systolic, diastolic or both) over any duration; comparison-persons without dementia who do not have elevated BPV; and outcome-dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.
KW - Blood pressure variability
KW - Hypertension
KW - Dementia
KW - Cognitive impairment
KW - Ambulatory blood pressure monitoring
KW - Systematic review
KW - Meta-analysis
KW - Protocol
KW - Etiology
KW - ANTIHYPERTENSIVE MEDICATION USE
KW - RANDOMIZED CONTROLLED-TRIALS
KW - ARTERY RISK DEVELOPMENT
KW - TO-VISIT VARIABILITY
KW - ALL-CAUSE MORTALITY
KW - ALZHEIMERS-DISEASE
KW - INCIDENT DEMENTIA
KW - YOUNG ADULTHOOD
KW - DECLINE
KW - HYPERTENSION
U2 - 10.1186/s13643-018-0811-9
DO - 10.1186/s13643-018-0811-9
M3 - (Systematic) Review article
C2 - 30322404
SN - 2046-4053
VL - 7
JO - Systematic Reviews
JF - Systematic Reviews
M1 - 163
ER -