Evidence map›Antihypertensives × blood pressure›PMID 29212812›Full record

Trial reportCirculation. Arrhythmia and electrophysiology2017

Pharmacologic Prevention of Incident Atrial Fibrillation: Long-Term Results From the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).

Thomas A Dewland, Elsayed Z Soliman, Jose-Miguel Yamal, Barry R Davis, Alvaro Alonso, Christine M Albert, Lara M Simpson, L Julian Haywood, Gregory M Marcus

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

Trial report in Circulation. Arrhythmia and electrophysiology, 2017. The graph read 1 number from its abstract, feeding 1 cell of the map, but it casts no vote: it is a later paper about NCT00000542, whose primary report (PMID 12479764) speaks for the trial. It reports registered trial NCT00000542. Cited by 6 papers.

1number the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.1field-weighted citation impact, top 20% 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.

Read, but not usablea number the graph found but could not read as for or against

Blood pressurecomparator not stated · hypertension, arrhythmiafeeds one cell of the map
HR 1.040.94 to 1.15
Compared with chlorthalidone, randomization to either lisinopril (hazard ratio, 1.04; 95% confidence interval, 0.94-1.15; CONCLUSIONS: Compared with chlorthalidone, treatment with lisinopril is not associated with a meaningful reduction in incident AF or AFL among older adults with a history of hypertension.
FeedsAntihypertensives×blood pressure

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Antihypertensives×blood pressure

No readable resultOpen on the map →What to test next →

3 readable studies in this cell: 1 favour the treatment, 2 find no difference, 0 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT00976495154 enrolled · 2009
Δ 3.26-1.55 to 8.08
Effect of the Million Hearts Cardiovascular Disease Risk Reduction Mod…PMID 34076665 · 2021
Δ -1.70-2.80 to -0.60
A pilot randomized clinical trial of gamification to increase medicati…PMID 41802527 · 2026
Δ 1.80-2.20 to 5.90

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · 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.

NCT00000542 phase3completed

Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)

Ran1993Registered outcomes0Posted comparisons0ConditionsCardiovascular Diseases, Coronary Disease, Diabetes Mellitus, Heart DiseasesArmsamlodipine, chlorthalidone, diet, fat-restricted, doxazosin, Inhibitors, ACE
PMID 11315826PMID 14688492PMID 12479764PMID 11165421PMID 12479771PMID 10789671PMID 9506192PMID 9486999PMID 9008261PMID 8968430PMID 8743044PMID 8722446other papers from this trial
Open the trial in the graph
5 · Its place in the literature

Who cites it

6 citing papers in PubMed, 18 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Thomas A DewlandFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Elsayed Z SolimanFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Jose-Miguel YamalFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Barry R DavisFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Alvaro AlonsoFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Christine M AlbertFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Lara M SimpsonFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
L Julian HaywoodFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.).
Gregory M MarcusFrom the Knight Cardiovascular Institute, Oregon Health & Science University, Portland (T.A.D.); Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.); University of Texas School of Public Health, Houston (J.-M.Y., B.R.D., L.M.S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.); Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.M.A.); Keck School of Medicine, University of Southern California, Los Angeles (L.J.H.); and Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.). marcusg@medicine.ucsf.edu.
University of Southern California · USBrigham and Women's Hospital · USOregon Health & Science University · USEmory University · USWake Forest University · US

Funding

CLINICAL TRIALS CENTER FOR ALLHAT-N01HC35130-268035130N01HC035130 · HC · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 1993 to 2005
$6.3M
American Heart Association-American Stroke Association 16EIA26410001NHLBI NIH HHS HHSN268201100036CNHLBI NIH HHS N01 HC035130
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundAlthough atrial fibrillation (AF) guidelines indicate that pharmacological blockade of the renin-angiotensin system may be considered for primary AF prevention in hypertensive patients, previous studies have yielded conflicting results. We sought to determine whether randomization to lisinopril reduces incident AF or atrial flutter (AFL) compared with chlorthalidone in a large clinical trial cohort with extended post-trial surveillance. METHODS AND

resultsWe performed a secondary analysis of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), a randomized, double-blind, active-controlled clinical trial that enrolled hypertensive individuals ≥55 years of age with at least one other cardiovascular risk factor. Participants were randomly assigned to receive amlodipine, lisinopril, or chlorthalidone. Individuals with elevated fasting low-density lipoprotein cholesterol levels were also randomized to pravastatin versus usual care. The primary outcome was the development of either AF or AFL as diagnosed by serial study ECGs or by Medicare claims data. Among 14 837 participants without prevalent AF or AFL, 2514 developed AF/AFL during a mean 7.5±3.2 years of follow-up. Compared with chlorthalidone, randomization to either lisinopril (hazard ratio, 1.04; 95% confidence interval, 0.94-1.15;

conclusionsCompared with chlorthalidone, treatment with lisinopril is not associated with a meaningful reduction in incident AF or AFL among older adults with a history of hypertension. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00000542.

Indexed as

AmlodipineAntihypertensive AgentsAtrial FibrillationAtrial FlutterChlorthalidoneDouble-Blind MethodFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypertensionIncidenceLisinoprilMaleMiddle AgedMyocardial InfarctionPrimary PreventionAmlodipineAntihypertensive AgentsChlorthalidoneHydroxymethylglutaryl-CoA Reductase InhibitorsLisinoprilantihypertensive agentsatrial fibrillationatrial flutterprimary preventionrenin-angiotensin system

Identifiers

PMID29212812
PMCPMC5728652
OpenAlexW2774708344

What OpenQuestion holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

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.