Evidence map›Paper›PMID 26762524›Full record

Trial reportCirculation2016

Effect of Intensive Versus Usual Blood Pressure Control on Kidney Function Among Individuals With Prior Lacunar Stroke: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes (SPS3) Randomized Trial.

Carmen A Peralta, Leslie A McClure, Rebecca Scherzer, Michelle C Odden, Carole L White, Michael Shlipak, Oscar Benavente, Pablo Pergola

Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059306 (Secondary Prevention of Small Subcortical Strokes), which is not on this map. Cited by 41 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 6 pooled it
8.5field-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.

NCT00059306 phase3completednot on this map

Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2003 to 2012Enrolled3,020ConditionsCerebrovascular Accident, HypertensionArmsaspirin, clopidogrel, Target of Blood Pressure, placebo
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 6 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Pooled it
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  12. Effects of Intensive Blood Pressure Lowering on Kidney Tubule Injury in CKD: A Longitudinal Subgroup Analysis in SPRINT.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019
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  14. Acute Declines in Renal Function during Intensive BP Lowering and Long-Term Risk of Death.Journal of the American Society of Nephrology : JASN · 2018
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Carmen A PeraltaFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.). carmenalicia.peralta@ucsf.edu.
Leslie A McClureFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Rebecca ScherzerFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Michelle C OddenFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Carole L WhiteFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Michael ShlipakFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Oscar BenaventeFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
Pablo PergolaFrom The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center (C.A.P., R.S., M.S.); University of Alabama at Birmingham (L.A.M.); Oregon State University, Corvallis (M.C.O.); University of Texas Health Science Center at San Antonio (C.L.W., P.P.); and University of British Columbia, Vancouver, Canada (O.B.).
The University of Texas Health Science Center at San Antonio · USUniversity of British Columbia · CAOregon State University · USUniversity of Alabama at Birmingham · US

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
A New Paradigm for Hypertension in the Elderly- Beyond AgeR01AG046206 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI ODDEN, MICHELLE CHRISTINA, PERALTA, CARMEN ALICIA · 2014 to 2018
$1.4M
A Triple Marker Approach To Optimize CKD Detection Among Black and White AdultsR03DK095877 · NIDDK · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI PERALTA, CARMEN ALICIA · 2012 to 2014
$514k
NIA NIH HHS 1R01AG046206-01A1NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG046206NIDDK NIH HHS 5R03DK095877-03
6 · The paper itself

Abstract

backgroundThe effect of intensive blood pressure (BP) lowering on kidney function among individuals with established cerebrovascular disease and preserved estimated glomerular filtration rate (eGFR) is not established. METHODS AND

resultsAmong 2610 participants randomized to a lower (<130 mm Hg) versus higher (130-149 mm Hg) systolic BP target with repeated measures of serum creatinine, we evaluated differences by study arm in annualized eGFR decline and rapid decline (eGFR decline >30%) using linear mixed models and logistic regression, respectively. We assessed associations of both treatment and kidney function decline with stroke, major vascular events, and the composite of stroke, death, major vascular events, or myocardial infarction using multivariable Cox regression, separately and jointly including a test for interaction. Analyses were conducted by treatment arm. Mean age was 63±11 years; 949 participants (36%) were diabetic; and mean eGFR was 80±19 mL·min(-1)·1.73 m(-2). At 9 months, achieved systolic BP was 137±15 versus 127±14 mm Hg in the higher versus lower BP group, and differences were maintained throughout follow-up (mean, 3.2 years). Compared with the higher target, the lower BP target had a -0.50-mL·min(-1)·1.73 m(-2) per year (95% confidence interval [CI], -0.79 to -0.21) faster eGFR decline. Differences were most pronounced during the first year (-2.1 mL·min(-1)·1.73 m(-2); 95% CI, -0.97 to -3.2), whereas rates of eGFR decline did not differ after year 1 (-0.095; 95% CI, -0.47 to 0.23). A total of 313 patients (24%) in the lower BP group had rapid kidney function decline compared with 247 (19%) in the higher BP group (odds ratio, 1.4; 95% CI, 1.1-1.6). Differences in rapid decline by treatment arm were apparent in the first year (odds ratio, 1.4; 95% CI, 1.1-1.8) but were not significant after year 1 (odds ratio, 1.0; 95% CI, 0.73-1.4). Rapid decline was associated with higher risk for stroke, major vascular events, and composite after full adjustment among individuals randomized to the higher BP target (stroke hazard ratio, 1.93; 95% CI, 1.15-3.21) but not the lower BP arm (stroke hazard ratio, 0.93; 95% CI, 0.50-1.75; all P for interaction <0.06).

conclusionsIn patients with prior lacunar stroke and relatively preserved kidney function, intensive BP lowering was associated with a greater likelihood of rapid kidney function decline. Differences were observed primarily during the first year of antihypertensive treatment. Rapid kidney function decline was not associated with increased risk for clinical events among those undergoing intensive BP lowering. CLINICAL

trial registrationURL: http://www.clinicalTrials.gov. Unique identifier: NCT00059306.

Indexed as

AgedBlood PressureBlood Pressure DeterminationDouble-Blind MethodDrug Therapy, CombinationFemaleFollow-Up StudiesGlomerular Filtration RateHumansKidneyMaleMiddle AgedPlatelet Aggregation InhibitorsSecondary PreventionStroke, LacunarTreatment OutcomePlatelet Aggregation Inhibitorscerebrovascular disordershypertensionkidneystroke

Identifiers

PMID26762524
PMCPMC4829068
OpenAlexW2270089292

What OpenQuestion holds

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Registered trials

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.