Evidence map›Paper›PMID 22895954›Full record

SynthesisThe Cochrane database of systematic reviews2012

Pharmacotherapy for mild hypertension.

Diana Diao, James M Wright, David K Cundiff, Francois Gueyffier

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 13 pooled it
17.5field-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

76 citing papers in PubMed, 13 syntheses or guidelines pooled it, 194 citations in OpenAlex.

  1. Pharmacotherapy for mild hypertension.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Blood pressure targets in adults with hypertension.The Cochrane database of systematic reviews · 2020
    Pooled it
  3. Screening strategies for hypertension.The Cochrane database of systematic reviews · 2020
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Atencion primaria · 2018
    Guideline
  7. First-line drugs for hypertension.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Eplerenone for hypertension.The Cochrane database of systematic reviews · 2017
    Pooled it
  9. Guideline
  10. Pooled it
  11. Pooled it
  12. Guideline
  13. Pooled it
  14. Trial
  15. Trial
  16. Acupuncture for patients with mild hypertension: A randomized controlled trial.Journal of clinical hypertension (Greenwich, Conn.) · 2019
    Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Diana DiaoFaculty of Medicine, University of British Columbia, Vancouver, Canada. dianadiao@gmail.com.
James M Wright
David K Cundiff
Francois Gueyffier
University of British Columbia · CALAC+USC Medical Center · USUniversité Claude Bernard Lyon 1 · FR

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundPeople with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomised controlled trial (RCT) evidence.

objectivesPRIMARY

objectiveTo quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP) 140-159 mmHg and/or diastolic BP 90-99 mmHg) and without cardiovascular disease. SEARCH

methodsWe searched CENTRAL (2011, Issue 1), MEDLINE (1948 to May 2011), EMBASE (1980 to May 2011) and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE) were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. SELECTION CRITERIA: RCTs of at least 1 year duration. DATA COLLECTION AND ANALYSIS: The outcomes assessed were mortality, stroke, coronary heart disease (CHD), total cardiovascular events (CVS), and withdrawals due to adverse effects. MAIN

resultsOf 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15). In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57), stroke (RR 0.51, 95% CI 0.24, 1.08), or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32). Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95%CI 4.14, 5.57), ARR 9%. AUTHORS'

conclusionsAntihypertensive drugs used in the treatment of adults (primary prevention) with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg) have not been shown to reduce mortality or morbidity in RCTs. Treatment caused 9% of patients to discontinue treatment due to adverse effects. More RCTs are needed in this prevalent population to know whether the benefits of treatment exceed the harms.

Indexed as

AdultAntihypertensive AgentsBlood PressureCoronary DiseaseDrug MonitoringHumansHypertensionRandomized Controlled Trials as TopicStrokeAntihypertensive Agents

Identifiers

PMID22895954
PMCPMC8985074
OpenAlexW3027268282

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.