Evidence map›Paper›PMID 26302093›Full record

Trial reportMetabolic syndrome and related disorders2015

Effect of Selective Mineralocorticoid Receptor Blockade on Flow-Mediated Dilation and Insulin Resistance in Older Adults with Metabolic Syndrome.

Moon-Hyon Hwang, Jeung-Ki Yoo, Meredith Luttrell, Thomas H Meade, Mark English, Demetra D Christou

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Metabolic syndrome and related disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 31% 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, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Moon-Hyon Hwang1 Department of Applied Physiology and Kinesiology, University of Florida , Gainesville, Florida.
Jeung-Ki Yoo1 Department of Applied Physiology and Kinesiology, University of Florida , Gainesville, Florida.
Meredith Luttrell3 Department of Human Physiology, University of Oregon , Eugene, Oregon.
Thomas H Meade4 Department of Cardiology, Baylor Scott and White Health, Texas A&M University , College Station, Texas.
Mark English5 Department of Family and Community Medicine, Baylor Scott and White Health, Texas A&M University , College Station, Texas.
Demetra D Christou1 Department of Applied Physiology and Kinesiology, University of Florida , Gainesville, Florida.
University of Florida · USBaylor Scott & White Health · USUniversity of Oregon · US

Funding

Endothelial Dysfunction in Older Adult Humans with the Metabolic SyndromeR03AG032067 · NIA · UNIVERSITY OF FLORIDA · PI CHRISTOU, DEMETRA · 2008 to 2009
$125k
NIA NIH HHS AG 032067
6 · The paper itself

Abstract

backgroundThe prevalence of metabolic syndrome is especially high in older adults. Metabolic syndrome is associated with impaired vascular endothelial function, insulin resistance, and increased risk for cardiovascular disease but the underlying mechanisms are not fully elucidated. Plasma aldosterone is independently associated with metabolic syndrome and is linked to endothelial dysfunction and insulin resistance. Thus, we hypothesized that mineralocorticoid receptor (MR) blockade would improve flow-mediated dilation and insulin resistance in older adults with metabolic syndrome.

methodsTo test this hypothesis, we conducted a balanced, randomized, double-blind, placebo-controlled, crossover study using selective MR blockade (eplerenone; 100 mg/day) for 1 month with 1 month washout in older adults with metabolic syndrome (62.6 ± 3.2 yrs; mean ± standard error). We evaluated brachial artery flow-mediated dilation (ultrasonography), oxidative stress (oxidized low-density lipoproteins and F2-isoprostanes) and insulin resistance (homeostatic model assessment).

resultsIn response to MR blockade, flow-mediated dilation (5.37 ± 0.85 vs. 5.98 ± 1.29%; placebo vs. eplerenone; P = 0.4), oxidized low-density lipoproteins (51.6 ± 11.5 vs. 56.1 ± 10.9 U/L; P = 0.6), and F2-isoprostanes (0.07 ± 0.02 vs. 0.06 ± 0.01 pg/mL; P = 0.3) did not improve. Insulin resistance also did not change following MR blockade (1.04 ± 0.26 vs. 1.38 ± 0.50; P = 0.6). However, MR blockade resulted in a large reduction (10 mmHg) in systolic blood pressure (140 ± 6 vs. 130 ± 6 mmHg; P = 0.02), with no significant change in diastolic blood pressure (81 ± 3 vs. 75 ± 2 mmHg; P = 0.2).

conclusionsOur data do not support a contributing role for MRs in endothelial dysfunction and insulin resistance in older adults with metabolic syndrome. However, our findings suggest MR activation is an important contributor to systolic hypertension in this patient group.

Indexed as

Insulin ResistanceAgedBrachial ArteryCross-Over StudiesDouble-Blind MethodEndothelium, VascularEplerenoneHumansMetabolic SyndromeMiddle AgedMineralocorticoid Receptor AntagonistsOxidative StressPlacebosRegional Blood FlowSpironolactoneUltrasonographyEplerenoneMineralocorticoid Receptor AntagonistsPlacebosSpironolactone

Identifiers

PMID26302093
PMCPMC4606035
OpenAlexW2107861279

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.