ArticleEuropean journal of epidemiology2021
Hypothetical blood-pressure-lowering interventions and risk of stroke and dementia.
Article in European journal of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Effect of Four Hemoglobin Transfusion Threshold Strategies in Patients With Acute Myocardial Infarction and Anemia : A Target Trial Emulation Using MINT Trial Data.Annals of internal medicine · 2024Trial
- Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial.European heart journal · 2022Trial
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Hypothetical interventional effect of health behaviors for improving depression symptoms among patients diagnosed with cancer: a g-formula based study.BMC public health · 2025Article
- Generalized framework for identifying meaningful heterogenous treatment effects in observational studies: A parametric data-adaptive G-computation approach.Statistical methods in medical research · 2025Article
- Racial and ethnic differences in the risk of dementia diagnosis under hypothetical blood pressure-lowering interventions: The Multi-Ethnic Study of Atherosclerosis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- [Hypothetical Alcohol Consumption Interventions and Hepatic Steatosis: A Longitudinal Study in a Large Cohort].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2024Article
- Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities.Journal of stroke · 2024Review
- On the estimation of the effect of weight change on a health outcome using observational data, by utilising the target trial emulation framework.International journal of obesity (2005) · 2023Observational
- Evaluating Model Specification When Using the Parametric G-Formula in the Presence of Censoring.American journal of epidemiology · 2023Article
- Implementation of the trial emulation approach in medical research: a scoping review.BMC medical research methodology · 2023Article
- Hypothetical intervention of targeted systolic blood pressure control of < 120 mmHg on renal prognosis for persons with stage 3-4 chronic kidney disease: an application of parametric g-formula using health checkup data in Japan.Clinical and experimental nephrology · 2023Article
- Initiation of Antihypertensive Medication from Midlife on Incident Dementia: The Health and Retirement Study.Journal of Alzheimer's disease : JAD · 2023Observational
- Incidence of cognitive impairment after hypothetical interventions on depression, nighttime sleep duration, and leisure activity engagement among older Chinese adults: An application of the parametric g-formula.Frontiers in public health · 2023Article
- Closing the Gap Between Observational Research and Randomized Controlled Trials for Prevention of Alzheimer Disease and Dementia.Epidemiologic reviews · 2022Article
- Association between the Systolic Blood Pressure Trajectory and Risk of Stroke in a Health-Management Population in Jiaozuo, China.Journal of healthcare engineering · 2022Article
- Turtles all the way down: do biological mechanisms for epidemiological observations always matter?European journal of epidemiology · 2021Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
We aimed to study the effects of hypothetical interventions on systolic blood pressure (SBP) and smoking on risk of stroke and dementia using data from 15 years of follow-up in the Rotterdam Study. We used data from 4930 individuals, aged 55-80 years, with no prior history of stroke, dementia or cognitive impairment, followed for 15 years within the Rotterdam Study, a population-based cohort. We defined the following sustained interventions on SBP: (1) maintaining SBP below 120 mmHg, (2) maintaining SBP below 140 mmHg, (3) reducing SBP by 10% if above 140 mmHg, (4) reducing SBP by 20% if above 140 mmHg, and a combined intervention of quitting smoking with each of these SBP-lowering strategies. We considered incident stroke and incident dementia diagnoses as outcomes. We applied the parametric g-formula to adjust for baseline and time-varying confounding. The observed 15-year risk for stroke was 10.7%. Compared to no specified intervention (i.e., the "natural course"), all interventions that involved reducing SBP were associated with a stroke risk reduction of about 10% (e.g., reducing SBP by 20% if above 140 mmHg risk ratio: 0.89; 95% CI 0.76, 1). Jointly intervening on SBP and smoking status further decreased the risk of stroke (e.g., risk ratio: 0.83; 95% CI 0.71, 0.94). None of the specified interventions were associated with a substantive change in dementia risk. Our study suggests that a joint intervention on SBP and smoking cessation during later life may reduce stroke risk, while the potential for reducing dementia risk were not observed.
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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.