Evidence map›Paper›PMID 27076600›Full record

ArticleAmerican journal of hypertension2016

Aldosterone Antagonists or Renin-Guided Therapy for Treatment-Resistant Hypertension: A Comparative Effectiveness Pilot Study in Primary Care.

Brent M Egan, Marilyn A Laken, Susan E Sutherland, Suparna Qanungo, Douglas O Fleming, Anne G Cook, William H Hester, Kelly W Jones, Gerard C Jebaily, Gregory T Valainis and 3 more

Registry-linked trialOpen access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of hypertension, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02167464 (Controlling Blood Pressure in Treatment Resistant Hypertension), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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.

NCT02167464 nacompletednot on this map

Controlling Blood Pressure in Treatment Resistant Hypertension: A Pilot Study

TypeinterventionalSponsorMedical University of South CarolinaRan2011 to 2015Enrolled70ConditionsHypertensionArmsRenin treatment-guided Therapeutics, Referral Hypertension specialist, Aldosterone Antagonist
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
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

13 authors at 4 institutions in 1 country.

Brent M EganCare Coordination Institute, Greenville Health System, Greenville, South Carolina, USA; University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA; began@ccihealth.org.
Marilyn A LakenCollege of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA;
Susan E SutherlandCare Coordination Institute, Greenville Health System, Greenville, South Carolina, USA;
Suparna QanungoCollege of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA;
Douglas O FlemingCare Coordination Institute, Greenville Health System, Greenville, South Carolina, USA; University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA;
Anne G CookDepartment of Family Medicine, AnMed Health, Anderson, South Carolina, USA;
William H HesterDepartment of Family Medicine, McLeod Regional Medical Center, Florence, South Carolina, USA;
Kelly W JonesDepartment of Family Medicine, McLeod Regional Medical Center, Florence, South Carolina, USA;
Gerard C JebailyDepartment of Family Medicine, McLeod Regional Medical Center, Florence, South Carolina, USA;
Gregory T ValainisCarolina Medical Affiliates, Spartanburg, South Carolina, USA;
Charles F WayFamily Diagnostic Associates, Holly Hill, South Carolina, USA.
Mary Beth WrightDepartment of Family Medicine, AnMed Health, Anderson, South Carolina, USA;
Robert A DavisCare Coordination Institute, Greenville Health System, Greenville, South Carolina, USA;
Prisma Health · USOrlando Regional Medical Center · USAnMed Health · USMedical University of South Carolina · US

Funding

Controlling Blood Pressure in Treatment Resistant Hypertension: A Pilot StudyR34HL105880 · NHLBI · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI EGAN, BRENT M, LAKEN, MARILYN · 2011 to 2012
$664k
NHLBI NIH HHS R34 HL105880
6 · The paper itself

Abstract

backgroundUncontrolled treatment-resistant hypertension (TRH), i.e., blood pressure (BP, mm Hg) ≥140/≥90mm Hg in and out of office on ≥3 different BP medications at optimal doses, is common and has a poor prognosis. Aldosterone antagonist (AA) and renin-guided therapy (RGT) are effective strategies for improving BP control in TRH but have not been compared.

methodsA comparative effectiveness TRH pilot study of AA vs. RGT was conducted in 4 primary care clinics with 2 each randomized to AA or RGT. The primary outcome was change in clinic BP defined by means of 5 automated office BP values. Eighty-nine patients with apparent TRH were screened and 44 met criteria for true TRH.

resultsBaseline characteristics of 20 patients in the AA (70% Black, 45% female, mean age: 57.4 years) and 24 patients in RGT (79% Black, 50% female, 57.8 years) arms were similar with baseline BP 162±5/90±3 vs. 153±3/84±3, respectively, P = 0.11/0.20. BP declined to 144±5/86±4 in AA vs. 132±4/75±3 in RGT, P = 0.07/0.01; BP was controlled to JNC7 (Seventh Joint National Committee Report) goal in 25% vs. 62.5%, respectively, P < 0.01. Although BP changes from baseline, the primary outcome, were not different (-17.6±5.1/-4.0±3.0 AA vs. -20.4±3.8/-9.7±2.0 RGT, P = 0.65/0.10.), more BP medications were added with AA than RGT (+0.9±0.1 vs. +0.4±0.1 per patient, P < 0.01).

conclusionsIn this TRH pilot study, AA and RGT lowered BP similarly, although fewer additional medications were required with RGT. A larger comparative effectiveness study could establish the utility of these treatment strategies for lowering BP of uncontrolled TRH patients in primary care.

Indexed as

Primary Health CareAngiotensin IFemaleHumansHypertensionMaleMiddle AgedMineralocorticoid Receptor AntagonistsPilot ProjectsReninAngiotensin IMineralocorticoid Receptor AntagonistsReninaldosterone antagonistsblood pressureclinical effectivenessrenin-guided therapytreatment-resistant hypertension.

Identifiers

PMID27076600
PMCPMC4941594
OpenAlexW2336568068

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.