Evidence map›Paper›PMID 23726159›Full record

Trial reportLancet (London, England)2013

Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial.

SPS3 Study Group, O R Benavente, C S Coffey, R Conwit, R G Hart, L A McClure, L A Pearce, P E Pergola, J M Szychowski

Erratum issued 2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Lancet (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 319 papers, 38 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
319citing papers in PubMed, 38 pooled it
40.5field-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.

NCT05169021 phase4not yet recruitingnot on this mapstarted 2021, after this paper: background citation

Folic Acid and Intensive Antihypertensive Therapy for Cerebrovascular and Cardiovascular Events Prevention Among Patients With Hypertension and Cerebral Small Vascular Diseases (FAITH)----A Multicenter, Randomized, Controlled, Open-label, 2x2 Factorial, Blinded End-point Trial

TypeinterventionalSponsorBeijing Tiantan HospitalRan2021 to 2028Enrolled15,000ConditionsCerebral Small Vessel Diseases, StrokeArmsAmlodipine folic acid 5.8mg+intensive antihypertensive therapy, Amlodipine folic acid 5.8mg+standard antihypertensive therapy, Amlodipine+intensive antihypertensive therapy, Amlodipine+standard antihypertensive therapy
NCT05690997 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Effect of Intensive Blood Pressure Control on Cerebral Blood Flow and Cognition in Ischaemic Stroke Patients With Severe Cerebral Small Vessel Disease

TypeinterventionalSponsorThe University of Hong KongRan2023 to 2025Enrolled104ConditionsSmall Vessel Cerebrovascular Disease, StrokeArmsIntensive treatment, Standard treatment
3 · Its place in the literature

Who cites it

319 citing papers in PubMed, 38 syntheses or guidelines pooled it, 752 citations in OpenAlex.

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  6. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  7. Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
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259 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.

SPS3 Study Group
O R Benavente
C S Coffey
R Conwit
R G Hart
L A McClure
L A Pearce
P E Pergola
J M Szychowski

Funding

SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES (SPSS)U01NS038529 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI BENAVENTE, OSCAR R · 2003 to 2012
$62.9M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
NCATS NIH HHS UL1 TR000439NINDS NIH HHS U01 NS038529NINDS NIH HHS U01NS038529
6 · The paper itself

Abstract

backgroundLowering of blood pressure prevents stroke but optimum target levels to prevent recurrent stroke are unknown. We investigated the effects of different blood-pressure targets on the rate of recurrent stroke in patients with recent lacunar stroke.

methodsIn this randomised open-label trial, eligible patients lived in North America, Latin America, and Spain and had recent, MRI-defined symptomatic lacunar infarctions. Patients were recruited between March, 2003, and April, 2011, and randomly assigned, according to a two-by-two multifactorial design, to a systolic-blood-pressure target of 130-149 mm Hg or less than 130 mm Hg. The primary endpoint was reduction in all stroke (including ischaemic strokes and intracranial haemorrhages). Analysis was done by intention to treat. This study is registered with ClinicalTrials.gov, number NCT 00059306.

findings3020 enrolled patients, 1519 in the higher-target group and 1501 in the lower-target group, were followed up for a mean of 3·7 (SD 2·0) years. Mean age was 63 (SD 11) years. After 1 year, mean systolic blood pressure was 138 mm Hg (95% CI 137-139) in the higher-target group and 127 mm Hg (95% CI 126-128) in the lower-target group. Non-significant rate reductions were seen for all stroke (hazard ratio 0·81, 95% CI 0·64-1·03, p=0·08), disabling or fatal stroke (0·81, 0·53-1·23, p=0·32), and the composite outcome of myocardial infarction or vascular death (0·84, 0·68-1·04, p=0·32) with the lower target. The rate of intracerebral haemorrhage was reduced significantly (0·37, 0·15-0·95, p=0·03). Treatment-related serious adverse events were infrequent.

interpretationAlthough the reduction in stroke was not significant, our results support that in patients with recent lacunar stroke, the use of a systolic-blood-pressure target of less than 130 mm Hg is likely to be beneficial.

fundingNational Institutes of Health-National Institute of Neurological Disorders and Stroke (NIH-NINDS).

Indexed as

Antihypertensive AgentsBlood PressureCerebral HemorrhageFemaleHumansHypertensionMaleMiddle AgedSecondary PreventionStroke, LacunarSystoleTime-to-TreatmentTreatment OutcomeAntihypertensive Agents

Identifiers

PMID23726159
PMCPMC3979302
OpenAlexW2127422554

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.