Evidence map›Paper›PMID 30194849›Full record

Trial reportBritish journal of clinical pharmacology2018

Impact of hydration status on haemodynamics, effects of acute blood pressure-lowering treatment, and prognosis after stroke.

Charlotte K Billington, Jason P Appleton, Eivind Berge, Nikola Sprigg, Mark Glover, Philip M W Bath

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 29% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Stroke Outcome Related to Initial Volume Status and Diuretic Use.Journal of the American Heart Association · 2022
    Article
  6. Article
  7. 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

6 authors at 2 institutions in 2 countries.

Charlotte K BillingtonDivision of Respiratory Medicine, University of Nottingham, Nottingham, UK.
Jason P AppletonStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0002-2604-4410
Eivind BergeDepartment of Internal Medicine and Cardiology, Oslo University Hospital, Oslo, Norway.
Nikola SpriggStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Mark GloverDivision of Respiratory Medicine, University of Nottingham, Nottingham, UK.
Philip M W BathStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
University of Nottingham · GBOslo University Hospital · NO

Funding

British Heart Foundation CS/14/4/30972Department of Health 10/104/24Department of Health 11/129/109Medical Research Council G0501797Medical Research Council MR/L006162/1
6 · The paper itself

Abstract

aimsAlthough high blood pressure (BP) is common in acute stroke and associated with poor outcome, the Efficacy of Nitric Oxide in Stroke (ENOS) trial showed no beneficial effect of antihypertensive treatment in this situation. Antihypertensive agents have accentuated effects in dehydrated patients. We assessed the impact of dehydration on haemodynamics, the effects of antihypertensive treatment, and prognosis in the ENOS trial.

methodsENOS randomized 4011 patients with acute stroke and raised systolic BP to a glyceryl trinitrate (GTN) patch or no GTN patch, and to continue or to stop existing antihypertensive treatment within 48 h of onset. The primary outcome was functional outcome (modified Rankin Scale, mRS) at day 90. Blood markers of dehydration at baseline were collected at two sites (n = 310) and their relationship with haemodynamics and outcome was assessed.

resultsThere were no significant associations between dehydration markers and fall in blood pressure from baseline to day 1, and no significant interaction with allocated treatment. Overall, increasing urea was associated with an unfavourable shift in mRS [odds ratio 3.43, 95% confidence interval (CI) 1.42, 8.32; P = 0.006] and increased risk of death at day 90 (hazard ratio 4.55, 95% CI 1.51, 13.66; P = 0.007).

conclusionsBlood pressure-lowering treatment was safe in dehydrated patients, with no precipitous changes in BP, thus supporting its use in acute stroke prior to blood markers of dehydration becoming available. Increased baseline urea was associated with poor prognosis after stroke.

Indexed as

Acute DiseaseAgedAged, 80 and overAntihypertensive AgentsBlood PressureFemaleHumansMaleMiddle AgedNitroglycerinPrognosisStrokeAntihypertensive AgentsNitroglycerinacute strokeblood pressuredehydrationglyceryl trinitrateintracerebral haemorrhageischaemic stroke

Identifiers

PMID30194849
PMCPMC6256053
OpenAlexW2891807358

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.