Evidence map›Paper›PMID 33020089›Full record

SynthesisBMJ open2020

Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis.

Jonathan Sen, Erin Chung, Christopher Neil, Thomas Marwick

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-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.

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

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  2. Article
  3. Article
  4. Review
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

4 authors at 2 institutions in 2 countries.

Jonathan SenBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Erin ChungGraduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada.
Christopher NeilBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Thomas MarwickBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia tom.marwick@bakeridi.edu.au.ORCID 0000-0001-9065-0899
Baker Heart and Diabetes Institute · AUUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes.

objectiveTo assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS.

designSystematic review and meta-analysis. DATA SOURCES: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019. STUDY ELIGIBILITY CRITERIA, APPRAISAL AND SYNTHESIS

methodsTwo independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in

main outcome measuresMortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fraction

resultsFrom 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin-angiotensin-aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance.

conclusionAHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.

Indexed as

Aortic Valve StenosisHypertensionAdultAntihypertensive AgentsBlood PressureHumansRandomized Controlled Trials as TopicRenin-Angiotensin SystemAntihypertensive Agentsadult cardiologyhypertensionvalvular heart disease

Identifiers

PMID33020089
PMCPMC7537451
OpenAlexW3091682145

What OpenQuestion holds

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LicenceCC BY-NC
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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.