title: Antihypertensive treatment in people with dementia.
abstract: BACKGROUND
  The range and magnitude of potential benefits and harms of antihypertensive treatment in people with dementia has not been previously established.
  
  
  METHODS
  A scoping review to identify potential domains of benefits and harms of antihypertensive therapy in people with dementia was undertaken. Systematic reviews of these domains were undertaken to examine the magnitude of the benefits or harms.
  
  
  RESULTS
  Potential outcome domains identified in the 155 papers in the scoping review were cardiovascular events, falls, fractures and syncope, depression, orthostatic hypotension, behavioral disturbances, polypharmacy risks, kidney problems, sleep problems, interactions with cholinesterase inhibitors, and pain. The systematic reviews across these domains identified relatively few studies done in people with dementia, and no convincing evidence of safety, benefit, or harm across any of them.
  
  
  CONCLUSIONS
  Given the lack of firm evidence of benefits or harm from antihypertensive therapy in people with dementia and the weak evidence for benefits in people over 80 years of age, the current presumption that the favorable evidence drawn from the treatment of nondemented people should be extrapolated to those with dementia is contentious. There is sufficient evidence to warrant particular caution and further research into treatment in this group of patients.
authors.affiliation: Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom. Electronic address: v.vanderwardt@nottingham.ac.uk.
authors.forename: Veronika
authors.initials: V
authors.lastname: van der Wardt
authors.affiliation: Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Pip
authors.initials: P
authors.lastname: Logan
authors.affiliation: Geriatric Medicine, University Hospitals of Leicester, Leicester, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Conroy
authors.affiliation: University of Nottingham, Nottingham, United Kingdom.
authors.forename: Rowan
authors.initials: R
authors.lastname: Harwood
authors.affiliation: Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Gladman
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003704:Dementia / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension; antihypertensive drugs; dementia