Evidence map›Paper›PMID 24299915›Full record

Trial reportJournal of hypertension2014

Predictors and outcomes of resistant hypertension among patients with coronary artery disease and hypertension.

Steven M Smith, Yan Gong, Eileen Handberg, Franz H Messerli, George L Bakris, Ali Ahmed, Anthony A Bavry, Carl J Pepine, Rhonda M Cooper-Dehoff

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of hypertension, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 2 pooled it
7.1field-weighted citation impact, top 2% 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

65 citing papers in PubMed, 2 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Trial
  4. Trial
  5. Trial
  6. Physician-pharmacist collaboration versus usual care for treatment-resistant hypertension.Journal of the American Society of Hypertension : JASH · 2016
    Trial
  7. Trial
  8. Article
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  11. Fixed-dose combinationFrontiers in pharmacology · 2026
    Article
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  17. Review
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5 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.

Steven M SmithaDepartment of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado bDepartment of Pharmacotherapy and Translational Research, College of Pharmacy cDivision of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida dDivision of Cardiology, St. Luke's-Roosevelt Hospital, New York eDepartment of Preventive Medicine, Rush University, Chicago, Illinois fDepartments of Medicine and Epidemiology, Schools of Medicine and Public Health, University of Alabama Birmingham, Birmingham, Alabama, USA.
Yan Gong
Eileen Handberg
Franz H Messerli
George L Bakris
Ali Ahmed
Anthony A Bavry
Carl J Pepine
Rhonda M Cooper-Dehoff
University of Florida · USRush University · USSt. Luke's-Roosevelt Hospital Center · USUniversity of Alabama at Birmingham · USUniversity of Colorado Anschutz Medical Campus · US

Funding

Pharmacogenomic Evaluation of Antihypertensive ResponsesU01GM074492 · NIGMS · UNIVERSITY OF FLORIDA · PI JOHNSON, JULIE A. · 2005 to 2014
$20.7M
Metabolic Effects of Antihypertensive DrugsK23HL086558 · NHLBI · UNIVERSITY OF FLORIDA · PI COOPER-DEHOFF, RHONDA M · 2007 to 2011
$672k
NHLBI NIH HHS K23 HL086558NHLBI NIH HHS K23HL086558NIGMS NIH HHS U01 GM074492NIGMS NIH HHS U01GM074492
6 · The paper itself

Abstract

objectiveResistant hypertension (res-HTN) is a challenging problem, but little is known of res-HTN in patients with coronary artery disease (CAD). In this post-hoc INternational VErapamil SR-Trandolapril STudy (INVEST) analysis, we assessed prevalence, predictors, and impact on outcomes of res-HTN in CAD patients with hypertension.

methodsParticipants (n=17190) were divided into three groups according to achieved blood pressure (BP): controlled (BP <140/90 mmHg on three or fewer drugs); uncontrolled (BP ≥ 40/90 mmHg on two or fewer drugs); or resistant (BP ≥ 40/90 mmHg on three drugs or any patient on at least four drugs).

resultsThe prevalence of res-HTN was 38%: significant predictors of res-HTN included heart failure [odds ratio (OR) 1.73], diabetes (OR 1.63), Black race (OR 1.50), and US residence (OR 1.50). Compared with controlled HTN, res-HTN had multivariate-adjusted association with higher risk of adverse outcomes {first occurrence of all-cause death, nonfatal myocardial infarction, or nonfatal stroke [hazard ratio 1.27, 95% confidence interval (CI) 1.13-1.43], and individual outcomes of all-cause death (hazard ratio 1.29, 95% CI 1.13-1.48), cardiovascular mortality (hazard ratio 1.47, 95% CI 1.21-1.78), and nonfatal stroke (hazard ratio 1.61, 95% CI 1.17-2.22), but not nonfatal myocardial infarction (hazard ratio 0.98, 95% CI 0.72-1.34)}. Adverse outcomes, except nonfatal stroke, did not differ in patients with res-HTN compared to uncontrolled HTN.

conclusionsRes-HTN is common in patients with CAD and hypertension, associated with poor prognosis, and linked with a number of conditions. Emphasis should be placed on recognizing those at risk for res-HTN and future studies should examine whether more aggressive treatment of res-HTN improves outcomes.

Indexed as

AgedAntihypertensive AgentsBlood PressureCoronary Artery DiseaseDrug ResistanceDrug Therapy, CombinationFemaleHumansHypertensionMaleMiddle AgedProspective StudiesRisk FactorsTreatment OutcomeAntihypertensive Agents

Identifiers

PMID24299915
PMCPMC4118668
OpenAlexW1986336039

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.