Trial reportHypertension (Dallas, Tex. : 1979)2017
Evidence for Reverse Causality in the Association Between Blood Pressure and Cardiovascular Risk in Patients With Chronic Kidney Disease.
Registry-linked trialOpen access · hybridFull text readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in Hypertension (Dallas, Tex. : 1979), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00125593 (Study of Heart and Renal Protection), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% of its field
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.
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.
Study of Heart and Renal Protection (SHARP): The Effects of Lowering LDL-cholesterol With Simvastatin 20mg Plus Ezetimibe 10mg in Patients With Chronic Kidney Disease: a Randomized Placebo-controlled Trial
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- Guideline-Directed Medical Therapy Attainment and Outcomes in Dialysis-Requiring Versus Nondialysis Chronic Kidney Disease in the ISCHEMIA-CKD Trial.Circulation. Cardiovascular quality and outcomes · 2022Trial
- Blood pressure and cardiovascular risk in adults with non-proteinuric chronic kidney disease without diabetes.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Characteristics and Determinants of Pulse Wave Velocity in Super Normal Vascular Aging (SUPERNOVA) Patients.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Article
- Systolic blood pressure time in target range within 24 hours and incident heart failure: insights from the real-world setting.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Commentary: Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women.Frontiers in public health · 2025Article
- Elucidating the complex interplay between chronic kidney disease and hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Review
- Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment in CKD.Kidney international reports · 2024Article
- Association of Pre-PCI Blood Pressure and No-Reflow in Patients with Acute ST-Elevation Coronary Infarction.Global heart · 2024Article
- BoXHED: Boosted eXact Hazard Estimator with Dynamic covariates.Proceedings of machine learning research · 2020Article
- Observational
- Intensive Blood Pressure Lowering in Patients With Renal Impairment and Lacunar Stroke.Journal of the American Heart Association · 2019Article
- Feasibility of Telemonitoring Blood Pressure in Patients With Kidney Disease (Oxford Heart and Renal Protection Study-1): Observational Study.JMIR cardio · 2018Article
- Age-specific association between blood pressure and vascular and non-vascular chronic diseases in 0·5 million adults in China: a prospective cohort study.The Lancet. Global health · 2018Article
- Article
- Risk Factors for Prognosis in Patients With Severely Decreased GFR.Kidney international reports · 2018Article
- Blood pressure parameters and morbid and mortal outcomes in nondialysis-dependent chronic kidney disease.Current opinion in nephrology and hypertension · 2018Review
- Physician perceptions of blood pressure control in patients with chronic kidney disease and target blood pressure achievement rate.Kidney research and clinical practice · 2017Article
- Blood pressure parameters are associated with all-cause and cause-specific mortality in chronic kidney disease.Kidney international · 2017Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 3 countries.
William HerringtonFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Natalie StaplinFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Parminder K JudgeFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Marion MafhamFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Jonathan EmbersonFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Richard HaynesFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
David C WheelerFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Robert WalkerFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Charlie TomsonFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Larry AgodoaFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Andrzej WiecekFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Sarah LewingtonFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Christina A ReithFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Martin J LandrayFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.).
Colin BaigentFrom the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), (W.H., N.S., P.K.J., M.M., J.E., R.H., S.L., C.A.R., M.J.L., C.B.) and Medical Research Council-Population Health Research Unit (MRC-PHRU) (P.K.J., J.E., R.H., S.L., C.B.), Nuffield Department of Population Health (NDPH), University of Oxford, United Kingdom; Centre for Nephrology, University College London, United Kingdom (D.C.W.); Dunedin School of Medicine, University of Otago, New Zealand (R.W.); Newcastle-upon-Tyne Hospitals NHS Foundation Trust, United Kingdom (C.T.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (L.A.); and Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland (A.W.). colin.baigent@ndph.ox.ac.uk.
SHARP Collaborative Group
National Institutes of Health · USUniversity of Otago · NZNational Institute of Diabetes and Digestive and Kidney Diseases · USUniversity College London · GB
Funding
British Heart Foundation CH/1996001/9454Medical Research Council MC_U137686853Medical Research Council MC_UU_12026/5
Abstract
Among those with moderate-to-advanced chronic kidney disease, the relationship between blood pressure (BP) and cardiovascular disease seems U shaped but is loglinear in apparently healthy adults. The SHARP (Study of Heart and Renal Protection) randomized 9270 patients with chronic kidney disease to ezetimibe/simvastatin versus matching placebo and measured BP at each follow-up visit. Cox regression was used to assess the association between BP and risk of cardiovascular disease among (1) those with a self-reported history of cardiovascular disease and (2) those with no such history and, based on plasma troponin-I concentration, a low probability of subclinical cardiac disease. A total of 8666 participants had a valid baseline BP and troponin-I measurement, and 2188 had at least 1 cardiovascular event during follow-up. After adjustment for relevant confounders, the association between systolic BP and cardiovascular events was U shaped, but among participants without evidence of previous cardiovascular disease, there was a positive loglinear association throughout the range of values studied. Among those with the lowest probability of subclinical cardiac disease, each 10 mm Hg higher systolic BP corresponded to a 27% increased risk of cardiovascular disease (hazard ratio, 1.27; 95% confidence interval, 1.11-1.44). In contrast, the relationship between diastolic BP and cardiovascular risk remained U shaped irrespective of cardiovascular disease history or risk of subclinical disease. In conclusion, the lack of a clear association between systolic BP and cardiovascular risk in this population seems attributable to confounding, suggesting that more intensive systolic BP reduction may be beneficial in such patients. CLINICAL
trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00125593.
Indexed as
AgedAnticholesteremic AgentsBlood PressureCardiovascular DiseasesDrug Therapy, CombinationEzetimibeFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsKidneyMaleMiddle AgedPrognosisRenal Insufficiency, ChronicRisk FactorsAnticholesteremic AgentsEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsSimvastatinblood pressurechronic kidney diseaseepidemiologytroponinvascular disease
Identifiers
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Registered trials
NCT00125593ClinicalTrials.gov
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.