Evidence map›Paper›PMID 26919870›Full record

Trial reportBMJ (Clinical research ed.)2016

Different systolic blood pressure targets for people with history of stroke or transient ischaemic attack: PAST-BP (Prevention After Stroke--Blood Pressure) randomised controlled trial.

Jonathan Mant, Richard J McManus, Andrea Roalfe, Kate Fletcher, Clare J Taylor, Una Martin, Satnam Virdee, Sheila Greenfield, F D Richard Hobbs

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

Trial report in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 16 pooled it
–field-weighted citation impact
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

45 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  2. Optimal blood pressure target for patients with prior stroke: A systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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  10. Blood pressure targets in adults with hypertension.The Cochrane database of systematic reviews · 2020
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  17. Intensive or standard blood pressure control in patients with a history of ischemic stroke: RESPECT post hoc analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Jonathan MantPrimary Care Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK jm677@medschl.cam.ac.uk.
Richard J McManusNuffield Department of Primary Care Health Sciences, NIHR School for Primary Care Research, University of Oxford, Oxford, OX2 6GG, UK.
Andrea RoalfePrimary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Kate FletcherPrimary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Clare J TaylorPrimary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Una MartinSchool of Clinical and Experimental Medicine, University of Birmingham.
Satnam VirdeePrimary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Sheila GreenfieldPrimary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
F D Richard HobbsNuffield Department of Primary Care Health Sciences, NIHR School for Primary Care Research, University of Oxford, Oxford, OX2 6GG, UK.

Funding

Department of Health CDF/01/017Department of Health DRF-2012-05-407Department of Health IS-SPC-0514-10043Department of Health NIHR-RP-02-12-015Department of Health RP-PG-0606-1153
6 · The paper itself

Abstract

objectiveTo assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease.

designOpen label randomised controlled trial.

setting99 general practices in England, with participants recruited in 2009-11.

participantsPeople with a history of stroke or transient ischaemic attack whose systolic blood pressure was 125 mm Hg or above.

interventionsIntensive systolic blood pressure target (<130 mm Hg or 10 mm Hg reduction from baseline if this was <140 mm Hg) or standard target (<140 mm Hg). Apart from the different target, patients in both arms were actively managed in the same way with regular reviews by the primary care team.

main outcome measureChange in systolic blood pressure between baseline and 12 months.

results529 patients (mean age 72) were enrolled, 266 to the intensive target arm and 263 to the standard target arm, of whom 379 were included in the primary analysis (182 (68%) intensive arm; 197 (75%) standard arm). 84 patients withdrew from the study during the follow-up period (52 intensive arm; 32 standard arm). Mean systolic blood pressure dropped by 16.1 mm Hg to 127.4 mm Hg in the intensive target arm and by 12.8 mm Hg to 129.4 mm Hg in the standard arm (difference between groups 2.9 (95% confidence interval 0.2 to 5.7) mm Hg; P=0.03).

conclusionsAiming for target below 130 mm Hg rather than 140 mm Hg for systolic blood pressure in people with cerebrovascular disease in primary care led to a small additional reduction in blood pressure. Active management of systolic blood pressure in this population using a <140 mm Hg target led to a clinically important reduction in blood pressure.Trial registration Current Controlled Trials ISRCTN29062286.

Indexed as

AgedAntihypertensive AgentsBlood PressureFemaleGeneral PracticeHumansHypertensionIschemic Attack, TransientMaleMiddle AgedStrokeSystoleAntihypertensive Agents

Identifiers

PMID26919870
PMCPMC4770816

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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.