Evidence map›Paper›PMID 10577635›Full record

Trial reportLancet (London, England)1999

Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study.

L Hansson, L H Lindholm, T Ekbom, B Dahlöf, J Lanke, B Scherstén, P O Wester, T Hedner, U de Faire

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 291 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
291citing papers in PubMed, 25 pooled it
66.7field-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

291 citing papers in PubMed, 25 syntheses or guidelines pooled it, 1,445 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Calcium channel blockers versus other classes of drugs for hypertension.The Cochrane database of systematic reviews · 2022
    Pooled it
  4. Calcium channel blockers versus other classes of drugs for hypertension.The Cochrane database of systematic reviews · 2021
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Beta-blockers for hypertension.The Cochrane database of systematic reviews · 2017
    Pooled it
  8. Guideline
  9. Guideline
  10. Pooled it
  11. Pooled it
  12. Beta-blockers for preventing stroke recurrence.The Cochrane database of systematic reviews · 2014
    Pooled it
  13. Pharmacological interventions for hypertension in children.The Cochrane database of systematic reviews · 2014
    Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Antihypertensive agents for preventing diabetic kidney disease.The Cochrane database of systematic reviews · 2012
    Pooled it
  18. Pooled it
  19. Guideline
  20. Pooled it

231 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

L HanssonDepartment of Public Health and Social Sciences, University of Uppsala, Sweden.
L H Lindholm
T Ekbom
B Dahlöf
J Lanke
B Scherstén
P O Wester
T Hedner
U de Faire
Lund University · SESahlgrenska University Hospital · SEUmeå University · SEKarolinska University Hospital · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy of new antihypertensive drugs has been questioned. We compared the effects of conventional and newer antihypertensive drugs on cardiovascular mortality and morbidity in elderly patients.

methodsWe did a prospective, randomised trial in 6614 patients aged 70-84 years with hypertension (blood pressure > or = 180 mm Hg systolic, > or = 105 mm Hg diastolic, or both). Patients were randomly assigned conventional antihypertensive drugs (atenolol 50 mg, metoprolol 100 mg, pindolol 5 mg, or hydrochlorothiazide 25 mg plus amiloride 2.5 mg daily) or newer drugs (enalapril 10 mg or lisinopril 10 mg, or felodipine 2.5 mg or isradipine 2-5 mg daily). We assessed fatal stroke, fatal myocardial infarction, and other fatal cardiovascular disease. Analysis was by intention to treat.

findingsBlood pressure was decreased similarly in all treatment groups. The primary combined endpoint of fatal stroke, fatal myocardial infarction, and other fatal cardiovascular disease occurred in 221 of 2213 patients in the conventional drugs group (19.8 events per 1000 patient-years) and in 438 of 4401 in the newer drugs group (19.8 per 1000; relative risk 0.99 [95% CI 0.84-1.16], p=0.89). The combined endpoint of fatal and non-fatal stroke, fatal and non-fatal myocardial infarction, and other cardiovascular mortality occurred in 460 patients taking conventional drugs and in 887 taking newer drugs (0.96 [0.86-1.08], p=0.49).

interpretationOld and new antihypertensive drugs were similar in prevention of cardiovascular mortality or major events. Decrease in blood pressure was of major importance for the prevention of cardiovascular events.

Indexed as

AgedAged, 80 and overAntihypertensive AgentsBlood PressureBody Mass IndexFemaleHumansHypertensionMaleMyocardial InfarctionProspective StudiesRegression AnalysisRiskStrokeSwedenAntihypertensive Agents

Identifiers

PMID10577635
OpenAlexW2139805666

What OpenQuestion holds

Textmetadata
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.