Evidence map›Paper›PMID 21386706›Full record

Trial reportBlood pressure monitoring2011

The role of ambulatory blood pressure monitoring compared with clinic and home blood pressure measures in evaluating moderate versus intensive treatment of hypertension with amlodipine/valsartan for patients uncontrolled on angiotensin receptor blocker monotherapy.

Thomas D Giles, Suzanne Oparil, Elizabeth O Ofili, Bertram Pitt, Das Purkayastha, Robert Hilkert, Rita Samuel, James R Sowers

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Blood pressure monitoring, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

5 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Thomas D GilesTulane University School of Medicine, New Orleans, Louisiana, USA. tgiles4@cox.net
Suzanne Oparil
Elizabeth O Ofili
Bertram Pitt
Das Purkayastha
Robert Hilkert
Rita Samuel
James R Sowers
Novartis (United States) · USMorehouse School of Medicine · USTulane University · USUniversity of Alabama at Birmingham · USUniversity of Michigan–Ann Arbor · USUniversity of Missouri · US

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025008 · NCRR · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2007 to 2011
$29.0M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Research Desogn and Biostatistics CoreU54MD007588 · NIMHD · MOREHOUSE SCHOOL OF MEDICINE · PI MONTGOMERY-RICE, VALERIE C. · 2012 to 2018
$24.8M
WARCEFU54RR026137 · NCRR · MOREHOUSE SCHOOL OF MEDICINE · PI CONERLY HOLLIDAY, RHONDA C · 2009 to 2011
$14.6M
Renewal Application for Clinical Research Education and Career Development (CRECDR25RR017694 · NCRR · MOREHOUSE SCHOOL OF MEDICINE · PI OFILI, ELIZABETH O. · 2002 to 2011
$5.5M
Heart Failure Clinical Research NetworkU01HL084891 · NHLBI · MOREHOUSE SCHOOL OF MEDICINE · PI OFILI, ELIZABETH O. · 2007 to 2011
$1.4M
NCATS NIH HHS UL1 TR000454NCRR NIH HHS 2R25RR017694-06A1NCRR NIH HHS R25 RR017694NCRR NIH HHS U54 RR026137NCRR NIH HHS UL1 RR025008NCRR NIH HHS UL1RR025008NHLBI NIH HHS U01 HL084891NHLBI NIH HHS U01HL084891NIMHD NIH HHS U54 MD007588
6 · The paper itself

Abstract

objectivesAmbulatory blood pressure monitoring (ABPM) has greater predictive value than office blood pressure (BP) with respect to hypertension-related target-organ damage and morbidity. ABPM in a subset of 80 patients from the Exforge Target Achievement trial (N=728) was used to compare the efficacy of intensive-treatment and moderate-treatment regimens of amlodipine/valsartan, and to determine whether treatment differences could be better assessed with ABPM than with office or home BP. Home BP was measured on the morning of clinic visits to minimize differences that timing might have on home versus office BP measures.

methodsA 12-week randomized, double-blind study in which hypertensive patients earlier uncontrolled (mean sitting systolic BP≥150 and <200 mmHg) on angiotensin receptor blocker monotherapy (other than valsartan) after 28 days or more (N=728) were randomized to amlodipine/valsartan treatment [10/320 mg (intensive) or 5/160 mg (moderate)]. Treatment-naive patients (in previous 28 days) or patients who failed on a nonangiotensin receptor blocker agent underwent a 28-day run-in period with a 20-mg or 40-mg dose of olmesartan, respectively.

resultsSignificantly greater 24-h ABP reductions from baseline to week 4 (primary time point) were observed with intensive versus moderate treatment (least-square mean systolic/diastolic BP reduction of -16.2/-10.1 vs. -9.5/-6.5 mmHg; P=0.0024/P=0.010 for least-square mean difference). Similarly, a significantly greater proportion of patients receiving an intensive treatment achieved ambulatory BP goal (<130/80 mmHg) at week 4 than did those receiving a moderate treatment (P=0.040). Treatment-group differences did not reach statistical significance for these end points when measured by office and home BP.

conclusionIn this first randomized trial evaluating the effects of intensive versus moderate dosing of the combination of amlodipine/valsartan, our data suggest that ABPM was a better method for assessing between-treatment differences than clinic or home BP recordings, although measurement of home BP as a single recording was a limitation of our trial.

Indexed as

AdultAgedAmlodipineAmlodipine, Valsartan Drug CombinationAngiotensin Receptor AntagonistsAntihypertensive AgentsBlood PressureBlood Pressure Monitoring, AmbulatoryDouble-Blind MethodDrug CombinationsFemaleHumansHypertensionMaleMiddle AgedSelf CareAmlodipineAmlodipine, Valsartan Drug CombinationAngiotensin Receptor AntagonistsAntihypertensive AgentsDrug CombinationsTetrazoles

Identifiers

PMID21386706
PMCPMC3915515
OpenAlexW2097853361

What OpenQuestion holds

Textmetadata
LicenceTDM
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.