Evidence map›Paper›PMID 31607143›Full record

Trial reportCirculation2019

Effects of Intensive Versus Standard Ambulatory Blood Pressure Control on Cerebrovascular Outcomes in Older People (INFINITY).

William B White, Dorothy B Wakefield, Nicola Moscufo, Charles R G Guttmann, Richard F Kaplan, Richard W Bohannon, Douglas Fellows, Charles B Hall, Leslie Wolfson

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01650402 (Intensive Versus Standard Blood Pressure Lowering to Prevent Functional Decline in Older People), which is not on this map. Cited by 69 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 13 pooled it
–field-weighted citation impact
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.

NCT01650402 nacompletednot on this map

Intensive Versus Standard Blood Pressure Lowering to Prevent Functional Decline in Older People

TypeinterventionalSponsorUConn HealthRan2011 to 2018Enrolled199ConditionsHypertension, Systolic, Cerebrovascular DiseaseArmsAnti-hypertensive therapy to SBP 130 mm Hg, Anti-hypertensive therapy to SBP 145 mm Hg
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 13 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Trial
  15. Trial
  16. Trial
  17. Article
  18. Article
  19. Article
  20. Article

9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

William B WhiteDivision of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center (W.B.W.), University of Connecticut School of Medicine, Farmington.
Dorothy B WakefieldDepartment of Neurology (D.B.W., L.W.), University of Connecticut School of Medicine, Farmington.
Nicola MoscufoDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (N.M., C.R.G.G.).
Charles R G GuttmannDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (N.M., C.R.G.G.).
Richard F KaplanDepartment of Psychiatry (R.F.K.), University of Connecticut School of Medicine, Farmington.
Richard W BohannonCollege of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC (R.W.B.).
Douglas FellowsDepartment of Diagnostic Imaging (D.F.), University of Connecticut School of Medicine, Farmington.
Charles B HallDepartment of Epidemiology and Population Health and Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.B.H.).
Leslie WolfsonDepartment of Neurology (D.B.W., L.W.), University of Connecticut School of Medicine, Farmington.

Funding

Intensive Blood Pressure Reduction to Lessen Functional DeclineR01AG022092 · NIA · UNIVERSITY OF CONNECTICUT SCH OF MED/DNT · PI WHITE, WILLIAM BARRY, WOLFSON, LESLIE · 2004 to 2017
$6.6M
NIA NIH HHS R01 AG022092
6 · The paper itself

Abstract

backgroundSubcortical microvascular disease represented by brain white matter hyperintensity on magnetic resonance imaging is associated with functional decline in older people with hypertension. The effects of 2 levels of 24-hour average systolic blood pressure (BP) on mobility, white matter disease progression, and cognitive function over 3 years were studied.

methodsThis trial was a prospective, randomized, blinded end-points study in patients ≥75 years of age with systolic hypertension and magnetic resonance imaging evidence of white matter hyperintensity lesions. Patients were randomized to a 24-hour mean systolic BP of ≤130 mm Hg (intensive treatment) versus ≤145 mm Hg (standard treatment) with antihypertensive therapies. Primary study outcomes were changes in mobility (gait speed) and accrual of white matter hyperintensity volume after 3 years. Changes in cognitive function (executive processing) and adverse events were also evaluated.

resultsIn 199 randomized patients, the mean age of the cohort was 80.5 years, and 54% were women; the average 24-hour systolic BP was 149 mm Hg. Goal BPs were achieved after a median treatment period of 3 to 4 months; at that time, the mean 24-hour systolic BP was 127.7 mm Hg in the intensive treatment group and 144.0 mm Hg in the standard treatment group for an average difference of 16.3 mm Hg. Changes in gait speed were not different between treatment groups (0.40±2.0 versus 0.42±2.7 s in the intensive treatment and standard treatment groups, respectively;

conclusionsIntensive lowering of ambulatory BP reduction in older patients with hypertension did not result in differences in mobility outcomes but was associated with a reduction in accrual of subcortical white matter disease. Over periods >3 years, a reduction in the accumulation of white matter disease may be a factor in conserving function. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01650402.

Indexed as

Accidental FallsAgedAged, 80 and overAntihypertensive AgentsBlood PressureBlood Pressure Monitoring, AmbulatoryCognitionDisease ProgressionDrug Therapy, CombinationExecutive FunctionFemaleHumansHypertensionLeukoencephalopathiesMagnetic Resonance ImagingMaleAntihypertensive Agentsblood pressurecerebrovasculardeterminationdisordersgait speedhypertension

Identifiers

PMID31607143
PMCPMC6848792

What OpenQuestion holds

Textmetadata
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.