Evidence map›Paper›PMID 27340919›Full record

Observational studyInternational journal of cardiology2016

Different associations between beta-blockers and other antihypertensive medication combinations with brachial blood pressure and aortic waveform parameters.

John D Sluyter, Alun D Hughes, Andrew Lowe, Kim H Parker, Carlos A Camargo, Bernhard Hametner, Siegfried Wassertheurer, Robert K R Scragg

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 11 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

8 authors at 6 institutions in 4 countries.

John D SluyterSchool of Population Health, University of Auckland, Auckland, New Zealand. Electronic address: j.sluyter@auckland.ac.nz.
Alun D HughesInstitute of Cardiovascular Sciences, University College London, London, UK.
Andrew LoweInstitute for Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand.
Kim H ParkerDepartment of Bioengineering, Imperial College London, London, UK.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Bernhard HametnerHealth & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria.
Siegfried WassertheurerHealth & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria.
Robert K R ScraggSchool of Population Health, University of Auckland, Auckland, New Zealand.
Austrian Institute of Technology · ATUniversity of Auckland · NZAuckland University of Technology · NZImperial College London · GBMassachusetts General Hospital · USUniversity College London · GB

Funding

British Heart Foundation PG/13/6/29934
6 · The paper itself

Abstract

backgroundComparing the relationships of antihypertensive medications with brachial blood pressure (BP) and aortic waveform parameters may help clinicians to predict the effect on the latter in brachial BP-based antihypertensive therapy. We aimed to make such comparisons with new waveform measures and a wider range of antihypertensive regimens than examined previously.

methodsCross-sectional analysis of 2933 adults (61% male; aged 50-84years): 1637 on antihypertensive treatment and 1296 untreated hypertensives. Sixteen medicine regimens of up to 4 combinations of drugs from 6 antihypertensive classes were analysed. Aortic systolic BP, augmentation index (AIx), excess pressure integral (EPI), backward pressure amplitude (Pb), reflection index (RI) and pulse wave velocity (PWV) were calculated from aortic pressure waveforms derived from suprasystolic brachial measurement.

resultsForest plots of single-drug class comparisons across regimens with the same number of drugs (for between 1- and 3-drug regimens) revealed that AIx, Pb, RI and/or loge(EPI) were higher (maximum difference=5.6%, 2.2mmHg, 0.0192 and 0.13 loge(mmHg⋅s), respectively) with the use of a beta-blocker compared with vasodilators and diuretics, despite no brachial systolic and diastolic BP differences. These differences were reduced (by 34-57%) or eliminated after adjustment for heart rate, and similar effects occurred when controlling for systolic ejection period or diastolic duration.

conclusionsBeta-blocker effects on brachial BP may overestimate effects on aortic waveform parameters. Compared to other antihypertensives, beta-blockers have weaker associations with wave reflection measures and EPI; this is predominantly due to influences on heart rate.

Indexed as

Adrenergic beta-AntagonistsAnkle Brachial IndexAntihypertensive AgentsAortaBlood PressurePulse Wave AnalysisAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsBlood Pressure DeterminationCalcium Channel BlockersCross-Sectional StudiesDiureticsDrug Therapy, CombinationFemaleFollow-Up StudiesAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsCalcium Channel BlockersDiureticsArterial stiffnessBeta-blockerCentral blood pressurePulse waveformVasodilating antihypertensive agentsWave reflection

Identifiers

PMID27340919
PMCPMC4964932
OpenAlexW2444381820

What OpenQuestion holds

Textmetadata
LicenceTDM
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.