Evidence map›Paper›PMID 32371759›Full record

ArticleJournal of hypertension2020

Functional health and white matter hyperintensities as effect modifiers of blood pressure-lowering on cognitive function and vascular events in older Secondary Prevention of Small Subcortical Strokes trial participants.

Manuel R Blum, Rebecca Scherzer, Jesse C Ikeme, Oscar R Benavente, Leslie A McClure, Carmen A Peralta, Michelle C Odden

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hypertension, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059306 (Secondary Prevention of Small Subcortical Strokes), which is not on this map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 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.

NCT00059306 phase3completednot on this map

Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2003 to 2012Enrolled3,020ConditionsCerebrovascular Accident, HypertensionArmsaspirin, clopidogrel, Target of Blood Pressure, placebo
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Higher blood pressure targets for hypertension in older adults.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Guideline
  3. 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

7 authors.

Manuel R BlumDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.
Rebecca ScherzerDivision of General Internal Medicine, Department of Medicine, San Francisco Veterans Affair Medical Center.
Jesse C IkemeKidney Health Research Collaborative, University of California.
Oscar R BenaventeSPS3 Coordinating Center.
Leslie A McClureDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
Carmen A PeraltaDepartment of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Michelle C OddenDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.

Funding

SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES (SPSS)U01NS038529 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI BENAVENTE, OSCAR R · 2003 to 2012
$62.9M
A New Paradigm for Hypertension in the Elderly- Beyond AgeR01AG046206 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI ODDEN, MICHELLE CHRISTINA, PERALTA, CARMEN ALICIA · 2014 to 2018
$1.4M
NIA NIH HHS R01 AG046206NINDS NIH HHS U01 NS038529
6 · The paper itself

Abstract

objectiveTo determine whether cerebral small vessel disease or disability modify the effect of SBP treatment on cognitive and vascular outcomes in older patients with recent lacunar stroke.

methodsParticipants aged at least 65 years of the Secondary Prevention of Small Subcortical Strokes Trial were randomized to a higher (130-149 mmHg) or lower (<130 mmHg) SBP target. The primary outcome was change in cognitive function (Cognitive Abilities Screening Instrument); secondary outcomes were incident mild cognitive impairment, stroke, major vascular events (all-stroke, myocardial infarction), and all-cause death. Results were stratified by severity of white matter hyperintensities (WMH; none/mild, moderate, severe) on baseline MRI, and by disability (no vs. at least one limitation in activities of daily living).

resultsOne thousand, two hundred and sixty-three participants (mean age 73.8 ± 5.9 years, 40% women) were included. Participants with severe WMH or disability had worse cognitive function at baseline and after a mean follow-up of 3.9 years. No significant interactions existed between treatment group and effect modifiers (WMH, disability) for change in cognitive function (P for interaction 0.42 and 0.66, respectively). A lower SBP target appeared more beneficial among those with worse WMH burden for vascular outcomes (P for interaction = 0.01 for stroke and 0.03 for major vascular events).

conclusionThere was no difference in the effect of lowering SBP to less than 130 mmHg on cognitive function by cerebral small vessel disease or disability among older adults with a history of lacunar stroke. Those with evidence of small vessel disease may derive greater benefit from lower SBP on prevention of subsequent vascular events.

trial registrationClinicaltrials.gov Identifier: NCT00059306.

Indexed as

Stroke, LacunarWhite MatterAgedAged, 80 and overBlood PressureClinical Trials, Phase III as TopicCognitionFemaleHumansMaleRandomized Controlled Trials as Topic

Identifiers

PMID32371759
PMCPMC8302036

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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.