Evidence map›Paper›PMID 25613952›Full record

ArticleBMJ open2015

The contribution of primary prevention medication and dietary change in coronary mortality reduction in England between 2000 and 2007: a modelling study.

M Guzman-Castillo, R Ahmed, N Hawkins, S Scholes, E Wilkinson, J Lucy, S Capewell, M O'Flaherty

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
4.3field-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

7 citing papers in PubMed, 24 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

M Guzman-CastilloDepartment of Public Health and Policy, University of Liverpool, Liverpool, UK.
R AhmedDepartment of Public Health and Policy, University of Liverpool, Liverpool, UK.
N HawkinsDivision of Cardiology, University of British Columbia, Vancouver, Canada.
S ScholesHealth and Social Surveys Research Group, University College London, UK.
E WilkinsonGlobal Public Health, University of Chester, Chester, UK.
J LucyPublic Health Wales, Swansea, UK.
S CapewellDepartment of Public Health and Policy, University of Liverpool, Liverpool, UK.
M O'FlahertyDepartment of Public Health and Policy, University of Liverpool, Liverpool, UK.
University of Liverpool · GBPublic Health Wales · GBUniversity College London · GBUniversity of British Columbia · CAUniversity of Chester · GB

Funding

Medical Research Council G0900847
6 · The paper itself

Abstract

objectiveTo analyse the falls in coronary heart disease (CHD) mortality in England between 2000 and 2007 and quantify the relative contributions from preventive medications and population-wide changes in blood pressure (BP) and cholesterol levels, particularly by exploring socioeconomic inequalities.

designA modelling study.

settingSources of data included controlled trials and meta-analyses, national surveys and official statistics.

participantsEnglish population aged 25+ in 2000-2007.

main outcome measuresNumber of deaths prevented or postponed (DPPs) in 2007 by socioeconomic status. We used the IMPACTSEC model which applies the relative risk reduction quantified in previous randomised controlled trials and meta-analyses to partition the mortality reduction among specific treatments and risk factor changes.

resultsBetween 2000 and 2007, approximately 20 400 DPPs were attributable to reductions in BP and cholesterol in the English population. The substantial decline in BP was responsible for approximately 13 000 DPPs. Approximately 1800 DPPs came from medications and some 11 200 DPPs from population-wide changes. Reduction in population BP prevented almost twofold more deaths in the most deprived quintile compared with the most affluent. Reduction in cholesterol resulted in approximately 7400 DPPs; approximately 5300 DPPs were attributable to statin use and approximately 2100 DPPs to population-wide changes. Statins prevented almost 50% more deaths in the most affluent quintile compared with the most deprived. Conversely, population-wide changes in cholesterol prevented threefold more deaths in the most deprived quintile compared with the most affluent.

conclusionsPopulation-wide secular changes in systolic blood pressure (SBP) and cholesterol levels helped to substantially reduce CHD mortality and the associated socioeconomic disparities. Mortality reductions were, in absolute terms, greatest in the most deprived quintiles, mainly reflecting their bigger initial burden of disease. Statins for high-risk individuals also made an important contribution but maintained socioeconomic inequalities. Our results strengthen the case for greater emphasis on preventive approaches, particularly population-based policies to reduce SBP and cholesterol.

Indexed as

AdultAgedAntihypertensive AgentsBlood PressureCholesterolCoronary DiseaseEnglandFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypertensionMaleMiddle AgedModels, StatisticalPrimary PreventionRisk FactorsAntihypertensive AgentsCholesterolHydroxymethylglutaryl-CoA Reductase Inhibitorsblood pressureCholesterolInequailities

Identifiers

PMID25613952
PMCPMC4316419
OpenAlexW2168915121

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC
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Registered trials

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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.