Evidence map›Paper›PMID 21947466›Full record

ArticleHypertension (Dallas, Tex. : 1979)2011

Isolated diastolic hypotension and incident heart failure in older adults.

Jason L Guichard, Ravi V Desai, Mustafa I Ahmed, Marjan Mujib, Gregg C Fonarow, Margaret A Feller, O James Ekundayo, Vera Bittner, Inmaculada B Aban, Michel White and 5 more

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
3.7field-weighted citation impact, top 6% 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

29 citing papers in PubMed, 54 citations in OpenAlex.

  1. Diastolic blood pressure as a predictor of short-term mortality in infective endocarditis.International journal of cardiology. Cardiovascular risk and prevention · 2025
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  15. Blood Pressure and Mortality: Joint Effect of Blood Pressure Measures.Journal of clinical cardiology and cardiovascular therapy · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 2 countries.

Jason L GuichardUniversity of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.
Ravi V Desai
Mustafa I Ahmed
Marjan Mujib
Gregg C Fonarow
Margaret A Feller
O James Ekundayo
Vera Bittner
Inmaculada B Aban
Michel White
Wilbert S Aronow
Thomas E Love
George L Bakris
Susan J Zieman
Ali Ahmed
Meharry Medical College · USNational Institute on Aging · USLehigh Valley Hospital-Pocono · USUniversity of Chicago · USCase Western Reserve University · USNew York Medical College · USUniversity of California, Los Angeles · US

Funding

Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01-HL085561NHLBI NIH HHS R01-HL085561-SNHLBI NIH HHS R01 HL097047NHLBI NIH HHS R01-HL097047
6 · The paper itself

Abstract

Aging is often associated with increased systolic blood pressure and decreased diastolic blood pressure. Isolated systolic hypertension or an elevated systolic blood pressure without an elevated diastolic blood pressure is a known risk factor for incident heart failure in older adults. In the current study, we examined whether isolated diastolic hypotension, defined as a diastolic blood pressure <60 mm Hg and a systolic blood pressure ≥100 mm Hg, is associated with incident heart failure. Of the 5795 Medicare-eligible community-dwelling adults age ≥65 years in the Cardiovascular Health Study, 5521 were free of prevalent heart failure at baseline. After excluding 145 individuals with baseline systolic blood pressure <100 mm Hg, the final sample included 5376 participants, of whom 751 (14%) had isolated diastolic hypotension. Propensity scores for isolated diastolic hypotension were calculated for each of the 5376 participants and used to match 545 and 2348 participants with and without isolated diastolic hypotension, respectively, who were balanced on 58 baseline characteristics. During >12 years of median follow-up, centrally adjudicated incident heart failure developed in 25% and 20% of matched participants with and without isolated diastolic hypotension, respectively (hazard ratio associated with isolated diastolic hypotension: 1.33 [95% CI: 1.10-1.61]; P=0.004). Among the 5376 prematch individuals, multivariable-adjusted hazard ratio for incident heart failure associated with isolated diastolic hypotension was 1.29 (95% CI: 1.09-1.53; P=0.003). As in isolated systolic hypertension, among community-dwelling older adults without prevalent heart failure, isolated diastolic hypotension is also a significant independent risk factor for incident heart failure.

Indexed as

AgedAged, 80 and overAge FactorsAgingBlood PressureCase-Control StudiesFemaleHeart FailureHumansHypotensionIncidenceKaplan-Meier EstimateMaleMultivariate AnalysisPrognosisProportional Hazards Models

Identifiers

PMID21947466
PMCPMC3390027
OpenAlexW2116552344

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.