Trial reportHypertension (Dallas, Tex. : 1979)2014
Excess pressure integral predicts cardiovascular events independent of other risk factors in the conduit artery functional evaluation substudy of Anglo-Scandinavian Cardiac Outcomes Trial.
Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph
Trial report in Hypertension (Dallas, Tex. : 1979), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 1 pooled it
8.5field-weighted citation impact, top 2% of its field
What it found
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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.
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.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 91 citations in OpenAlex.
- The modified arterial reservoir: An update with consideration of asymptotic pressure (Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2020Pooled it
- Identification of Distinct Arterial Waveform Clusters and a Longitudinal Evaluation of Their Clinical Usefulness.Hypertension (Dallas, Tex. : 1979) · 2019Trial
- Effect of Monthly, High-Dose, Long-Term Vitamin D Supplementation on Central Blood Pressure Parameters: A Randomized Controlled Trial Substudy.Journal of the American Heart Association · 2017Trial
- The theoretical basis of reservoir pressure in arteries.Experimental physiology · 2026Article
- Interaction between systemic arterial reservoir behavior and cerebrovascular vasoreactivity during acute controlled hypocapnia.Scientific reports · 2026Article
- Continuous monitoring of intra-abdominal pressure: cumulative pressure exposure predicts early acute kidney injury in animal model.World journal of emergency surgery : WJES · 2026Article
- Effects of Pre-Dialysis Fluid Overload, Intradialytic Relative Blood Volume Levels, and Cumulative Ultrafiltration Volume on Pulse Wave-Derived Features during Hemodialysis: Results from a Longitudinal Cohort Study.Kidney & blood pressure research · 2026Article
- Hemodynamic Markers Predict Outcomes a Decade After Acute Coronary Syndrome.Journal of clinical medicine · 2025Article
- Reservoir-excess pressure parameters are independently associated with NT-proBNP in older adults.ESC heart failure · 2024Article
- Carotid wave analysis in young adults with a history of adolescent anorexia nervosa: a case control study.Journal of eating disorders · 2024Article
- Arterial Blood Pressure Features of Hypertensive Patients with Typical and Atypical 460 nm Skin Fluorescence Response to Transient Ischaemia.Journal of clinical medicine · 2023Article
- Non-Invasive Pressure-Only Aortic Wave Intensity Evaluation Using Hybrid Fourier Decomposition-Machine Learning Approach.IEEE transactions on bio-medical engineering · 2023Article
- Increased Excess Pressure After Creation of an Arteriovenous Fistula in End-Stage Renal Disease.American journal of hypertension · 2022Article
- Carotid Reservoir Pressure Decrease After Prolonged Head Down Tilt Bed Rest in Young Healthy Subjects Is Associated With Reduction in Left Ventricular Ejection Time and Diastolic Length.Frontiers in physiology · 2022Article
- Features and implications of higher systolic central than peripheral blood pressure in patients at very high risk of atherosclerotic cardiovascular disease.Journal of human hypertension · 2021Article
- Physiological and clinical insights from reservoir-excess pressure analysis.Journal of human hypertension · 2021Review
- Reservoir-Excess Pressure Parameters Independently Predict Cardiovascular Events in Individuals With Type 2 Diabetes.Hypertension (Dallas, Tex. : 1979) · 2021Article
- Brachial-cuff excess pressure is associated with carotid intima-media thickness among Australian children: a cross-sectional population study.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Intrinsic Frequencies of Carotid Pressure Waveforms Predict Heart Failure Events: The Framingham Heart Study.Hypertension (Dallas, Tex. : 1979) · 2021Article
- Influence of Renal Transplantation and Living Kidney Donation on Large Artery Stiffness and Peripheral Vascular Resistance.American journal of hypertension · 2020Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 1 country.
Justin E DaviesFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Peter LacyFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Therese TillinFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
David CollierFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
J Kennedy CruickshankFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Darrel P FrancisFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Anura MalaweeraFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Jamil MayetFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Alice StantonFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Bryan WilliamsFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Kim H ParkerFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Simon A McG ThomFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.).
Alun D HughesFrom the International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College Healthcare NHS Trust (J.E.D., D.P.F., A.M., J.M., S.A.M.T.) and Department of Bioengineering (K.H.P.), Imperial College London, London, United Kingdom; Institute of Cardiovascular Science and National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London, London, United Kingdom (P.L., T.T., B.W., A.D.H.); Department of Clinical Pharmacology, William Harvey Research Institute, Bart's and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom (D.C.); Cardiovascular Medicine and Nutrition at King's College London, London, United Kingdom (J.K.C.); and Royal College of Surgeons in Ireland, St Stephen's Green, Dublin, Ireland (A.S.). alun.hughes@ucl.ac.uk.
National Institute for Health Research · GBWilliam Harvey Research Institute · GBKing's College London · GBUniversity College London · GB
Funding
British Heart Foundation FS/10/38/28268British Heart Foundation PG/13/6/29934Medical Research Council MC_PC_13090
Abstract
Excess pressure integral (XSPI), a new index of surplus work performed by the left ventricle, can be calculated from blood pressure waveforms and may indicate circulatory dysfunction. We investigated whether XSPI predicted future cardiovascular events and target organ damage in treated hypertensive individuals. Radial blood pressure waveforms were acquired by tonometry in 2069 individuals (aged, 63±8 years) in the Conduit Artery Functional Evaluation (CAFE) substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Measurements of left ventricular mass index (n=862) and common carotid artery intima media thickness (n=923) were also performed. XSPI and the integral of reservoir pressure were lower in people treated with amlodipine±perindopril than in those treated with atenolol±bendroflumethiazide, although brachial systolic blood pressure was similar. A total of 134 cardiovascular events accrued during a median 3.4 years of follow-up; XSPI was a significant predictor of cardiovascular events after adjustment for age and sex, and this relationship was unaffected by adjustment for conventional cardiovascular risk factors or Framingham risk score. XSPI, central systolic blood pressure, central augmentation pressure, central pulse pressure, and integral of reservoir pressure were correlated with left ventricular mass index, but only XSPI, augmentation pressure, and central pulse pressure were associated positively with carotid artery intima media thickness. Associations between left ventricular mass index, XSPI, and integral of reservoir pressure and carotid artery intima media thickness and XSPI were unaffected by multivariable adjustment for other covariates. XSPI is a novel indicator of cardiovascular dysfunction and independently predicts cardiovascular events and targets organ damage in a prospective clinical trial.
Indexed as
Antihypertensive AgentsBlood PressureCardiovascular DiseasesCardiovascular SystemCarotid Artery, CommonCarotid Intima-Media ThicknessFemaleHumansHypertensionMaleMiddle AgedProspective StudiesRisk FactorsVentricular Function, LeftAntihypertensive Agentsblood pressurecardiovascular diseasescarotid intima thicknesshypertensionleft ventricular hypertrophypulse wave analysis
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