Evidence map›Paper›PMID 32172015›Full record

ArticleJournal of the neurological sciences2020

Low blood pressure levels & incident stroke risk among elderly Ghanaians with hypertension.

Fred Stephen Sarfo, Linda Meta Mobula, Titus Adade, Yvonne Commodore-Mensah, Martin Agyei, Collins Kokuro, Rexford Adu-Gyamfi, Christiana Duah, Bruce Ovbiagele

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

Article in Journal of the neurological sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 17% 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

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
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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

9 authors at 5 institutions in 2 countries.

Fred Stephen SarfoDepartment of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com.
Linda Meta MobulaJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Titus AdadeDepartment of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Yvonne Commodore-MensahJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Martin AgyeiDepartment of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Collins KokuroDepartment of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Rexford Adu-GyamfiDepartment of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Christiana DuahKumasi South Regional Hospital, Kumasi, Ghana.
Bruce OvbiageleUniversity of California San Francisco, USA.
Komfo Anokye Teaching Hospital · GHJohns Hopkins University · USKwame Nkrumah University of Science and Technology · GHKumasi Technical University · GHUniversity of California, San Francisco · US

Funding

Phone-based Intervention Under Nurse Guidance after Stroke (PINGS)R21NS094033 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI OVBIAGELE, BRUCE · 2015 to 2016
$337k
NINDS NIH HHS R21 NS094033
6 · The paper itself

Abstract

backgroundClinical trial data indicate that more intensive blood pressure (BP) lowering below standard cut-off targets is associated with lower risks of strokes in the elderly. There is a relative paucity of real-world practice data on this issue, especially among Africans.

objectiveTo assess BP control rates, its determinants, and whether a lower BP < 120/80 mmHg is associated with a lower incident stroke risk among elderly Ghanaians with hypertension.

methodsWe retrospectively evaluated data, which were prospectively collected as part of a cohort study involving adults with hypertension and/or diabetes in 5 Ghanaian hospitals. BP control was defined using the JNC-8 guideline of <150/90 mmHg for elderly with hypertension aged >60 years or 140/90 mmHg for those with diabetes mellitus. Risk factors for poor BP control were assessed using multivariable logistic regression models. We calculated incident stroke risk over an 18-month follow-up at 3 BP cut-off's of <120/80, 120-159/80-99, and > 160/100 mmHg.

resultsOf the 1365 elderly participants with hypertension, 38.2% had diabetes mellitus and 45.8% had uncontrolled BP overall. Factors associated with uncontrolled BP were higher number of antihypertensive medications prescribed adjusted odds ratio of 1.45 (95% CI: 1.27-1.66), and having diabetes 2.56 (1.99-3.28). Among the elderly, there were 0 stroke events/100py for BP < 120/80 mmHg, 1.98 (95%CI: 1.26-2.98) for BP between 120 and 159/80-99 mmHg and 2.46 events/100py (95% CI: 1.20-4.52 at BP > 160/100 mmHg.

conclusionA lower BP target <120/80 mmHg among elderly Ghanaians with hypertension is associated with a signal of lower incident stroke risk. Pragmatic trials are needed to evaluate lower BP targets on stroke incidence in Africa.

Indexed as

HypertensionHypotensionStrokeAdultAgedAntihypertensive AgentsBlood PressureCohort StudiesGhanaHumansRetrospective StudiesRisk FactorsAntihypertensive AgentsAfricaBP thresholdsElderlyStroke risk

Identifiers

PMID32172015
PMCPMC7250714
OpenAlexW3009171849

What OpenQuestion holds

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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.