Evidence map›Paper›PMID 26419648›Full record

SynthesisBMJ (Clinical research ed.)2015

Usual blood pressure, peripheral arterial disease, and vascular risk: cohort study of 4.2 million adults.

Connor A Emdin, Simon G Anderson, Thomas Callender, Nathalie Conrad, Gholamreza Salimi-Khorshidi, Hamid Mohseni, Mark Woodward, Kazem Rahimi

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 6 pooled it
10.3field-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.

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

61 citing papers in PubMed, 6 syntheses or guidelines pooled it, 151 citations in OpenAlex.

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  15. Peripheral artery disease In West Africans with diabetes: a risk factor profile analysis.International journal of cardiology. Cardiovascular risk and prevention · 2025
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1 more citing papers are in PubMed but not listed here.

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

8 authors at 3 institutions in 3 countries.

Connor A EmdinThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Simon G AndersonThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Thomas CallenderThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Nathalie ConradThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Gholamreza Salimi-KhorshidiThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Hamid MohseniThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.
Mark WoodwardThe George Institute for Global Health, University of Sydney, Sydney, Australia Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
Kazem RahimiThe George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK kazem.rahimi@cardiov.ox.ac.uk.
University of Oxford · GBGeorge Institute for Global Health · GBUniversity of Sydney · AU

Funding

Department of Health CDF-2013-06-012
6 · The paper itself

Abstract

objectivesTo determine the subgroup specific associations between usual blood pressure and risk of peripheral arterial disease, and to examine the relation between peripheral arterial disease and a range of other types of vascular disease in a large contemporary cohort.

designCohort study.

settingLinked electronic health records from 1990 to 2013 in the United Kingdom.

participants4,222,459 people aged 30-90 years, registered at a primary care practice for at least one year and with a blood pressure measurement.

main outcome measuresTime to first diagnosis of new onset peripheral arterial disease and time to first diagnosis of 12 different vascular events.

resultsA 20 mm Hg higher than usual systolic blood pressure was associated with a 63% higher risk of peripheral arterial disease (hazard ratio 1.63, 95% confidence interval 1.59 to 1.66). The strength of the association declined with increasing age and body mass index (P<0.001 for interaction) but was not modified by sex or smoking status. Peripheral arterial disease was associated with an increased risk of 11 different vascular events, including ischaemic heart disease (1.68, 1.58 to 1.79), heart failure (1.63, 1.52 to 1.75), aortic aneurysm (2.10, 1.79 to 2.45), and chronic kidney disease (1.31, 1.25 to 1.38), but not haemorrhagic stroke. The most common initial vascular event among those with peripheral arterial disease was chronic kidney disease (24.4% of initial events), followed by ischaemic heart disease (18.5% of initial events), heart failure (14.7%), and atrial fibrillation (13.2%). Overall estimates from this cohort were consistent with those derived from traditional studies when we pooled the findings in two meta-analyses.

conclusionsRaised blood pressure is a strong risk factor for peripheral arterial disease in a range of patient subgroups. Furthermore, clinicians should be aware that those with established peripheral arterial disease are at an increased risk of a range of other vascular events, including chronic kidney disease, ischaemic heart disease, heart failure, atrial fibrillation, and stroke.

Indexed as

Blood PressureAdultAgedAged, 80 and overAge DistributionBody Mass IndexFemaleHumansHypertensionIncidenceMaleMiddle AgedPeripheral Arterial DiseaseProspective StudiesRisk FactorsUnited Kingdom

Identifiers

PMID26419648
PMCPMC4586462
OpenAlexW2265755165

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.