Evidence map›Paper›PMID 10030325›Full record

Trial reportLancet (London, England)1999

Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial.

L Hansson, L H Lindholm, L Niskanen, J Lanke, T Hedner, A Niklason, K Luomanmäki, B Dahlöf, U de Faire, C Mörlin and 3 more

Abstract readClinical TrialComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 379 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
379citing papers in PubMed, 17 pooled it
95.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

379 citing papers in PubMed, 17 syntheses or guidelines pooled it, 2,010 citations in OpenAlex.

  1. Pooled it
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  6. Guideline
  7. THE IMPACT OF CARDIOVASCULAR DRUGS ON GLYCEMIC CONTROL: A REVIEW.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2017
    Pooled it
  8. Beta-blockers for hypertension.The Cochrane database of systematic reviews · 2017
    Pooled it
  9. Guideline
  10. Beta-blockers for preventing stroke recurrence.The Cochrane database of systematic reviews · 2014
    Pooled it
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  12. Pooled it
  13. Antihypertensive agents for preventing diabetic kidney disease.The Cochrane database of systematic reviews · 2012
    Pooled it
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  16. Guideline
  17. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2006
    Pooled it
  18. Trial
  19. Trial
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319 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 2 countries.

L HanssonDepartment of Public Health and Social Sciences, University of Uppsala, Sweden.
L H Lindholm
L Niskanen
J Lanke
T Hedner
A Niklason
K Luomanmäki
B Dahlöf
U de Faire
C Mörlin
B E Karlberg
P O Wester
J E Björck
Bristol-Myers Squibb (Sweden) · SEUmeå University · SEHelsinki University Hospital · FIKarolinska University Hospital · SEKuopio University Hospital · FILinköping University Hospital · SELund University · SESahlgrenska University Hospital · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAngiotensin-converting-enzyme (ACE) inhibitors have been used for more than a decade to treat high blood pressure, despite the lack of data from randomised intervention trials to show that such treatment affects cardiovascular morbidity and mortality. The Captopril Prevention Project (CAPPP) is a randomised intervention trial to compare the effects of ACE inhibition and conventional therapy on cardiovascular morbidity and mortality in patients with hypertension.

methodsCAPPP was a prospective, randomised, open trial with blinded endpoint evaluation. 10,985 patients were enrolled at 536 health centres in Sweden and Finland. Patients aged 25-66 years with a measured diastolic blood pressure of 100 mm Hg or more on two occasions were randomly assigned captopril or conventional antihypertensive treatment (diuretics, beta-blockers). Analysis was by intention-to-treat. The primary endpoint was a composite of fatal and non-fatal myocardial infarction, stroke, and other cardiovascular deaths.

findingsOf 5492 patients assigned captopril and 5493 assigned conventional therapy, 14 and 13, respectively, were lost to follow-up. Primary endpoint events occurred in 363 patients in the captopril group (11.1 per 1000 patient-years) and 335 in the conventional-treatment group (10.2 per 1000 patient-years; relative risk 1.05 [95% CI 0.90-1.22], p=0-52). Cardiovascular mortality was lower with captopril than with conventional treatment (76 vs 95 events; relative risk 0.77 [0.57-1-04], p=0.092), the rate of fatal and non-fatal myocardial infarction was similar (162 vs 161), but fatal and non-fatal stroke was more common with captopril (189 vs 148; 1.25 [1-01-1-55]. p=0.044).

interpretationCaptopril and conventional treatment did not differ in efficacy in preventing cardiovascular morbidity and mortality. The difference in stroke risk is probably due to the lower levels of blood pressure obtained initially in previously treated patients randomised to conventional therapy.

Indexed as

Adrenergic beta-AntagonistsAdultAgedAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBlood PressureCaptoprilCause of DeathCerebrovascular DisordersConfidence IntervalsDiureticsFemaleFollow-Up StudiesHeart DiseasesHumansHypertensionAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsCaptoprilDiuretics

Identifiers

PMID10030325
OpenAlexW2102979143

What OpenQuestion holds

Texttitle and abstract
measurements read1
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.