Evidence map›Paper›PMID 33825813›Full record

ArticleAmerican journal of hypertension2021

Long-Term Variability of Blood Pressure, Cardiovascular Outcomes, and Mortality: The Look AHEAD Study.

Arnaud D Kaze, Prasanna Santhanam, Sebhat Erqou, Matthew Yuyun, Alain G Bertoni, Rexford S Ahima, Justin B Echouffo-Tcheugui

Abstract read
In one paragraph

Article in American journal of hypertension, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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

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

3 citing papers in PubMed.

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4 · The record

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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.

Arnaud D KazeDepartment of Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA.
Prasanna SanthanamDepartment of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Sebhat ErqouDepartment of Medicine, Providence Veterans Affairs Medical Center and Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Matthew YuyunDepartment of Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
Alain G BertoniDepartment of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Rexford S AhimaDepartment of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Justin B Echouffo-TcheuguiDepartment of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-8460-1617

Funding

Establishing the Pathways Between Diabetes and Cardiac Dysfunction: Epidemiology, Biomarkers, and ImagingK23HL153774 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI ECHOUFFO TCHEUGUI, JUSTIN BASILE · 2020 to 2024
$991k
NHLBI NIH HHS K23 HL153774
6 · The paper itself

Abstract

backgroundWe evaluated the associations of visit-to-visit blood pressure (BP) variability with incident cardiovascular disease (CVD) and deaths in adults with type 2 diabetes.

methodsWe analyzed 4,152 participants in Look AHEAD (Action for Health in Diabetes) free of CVD events and deaths during the first 36 months of follow-up. Variability of systolic BP (SBP) and diastolic BP (DBP) across 4 annual visits was assessed using the intraindividual SD, variation independent of the mean, and coefficient of variation. Cox regression was used to generate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD (myocardial infarction [MI], stroke, or CVD-related deaths) and mortality.

resultsOver a median of 6.6 years, there were 220 MIs, 105 stroke cases, 62 CVD-related deaths, and 236 deaths. After adjustment for confounders including average BP, the aHRs for the highest (vs. lowest) tertile of SD of SBP were 1.98 (95% CI 1.01-3.92), 1.25 (95% CI 0.90-1.72), 1.26 (95% CI 0.96-1.64), 1.05 (95% CI 0.75-1.46), and 1.64 (95% CI 0.99-2.72) for CVD mortality, all-cause mortality, CVD, MI, and stroke, respectively. The equivalent aHRs for SD of DBP were 1.84 (95% CI 0.98-3.48), 1.43 (95% CI 1.03-1.98), 1.19 (95% CI 0.91-1.56), 1.14 (95% CI 0.82-1.58), and 0.97 (95% CI 0.58-1.60), respectively.

conclusionsIn a large sample of individuals with type 2 diabetes, a greater variability in SBP was associated with higher cardiovascular mortality and CVD events; a higher variability in DBP was linked to increased overall and cardiovascular mortality.

Indexed as

Blood PressureCardiovascular DiseasesAdultDiabetes Mellitus, Type 2Follow-Up StudiesHumansIncidenceblood pressureblood pressure variabilitycardiovascular diseasesdiabeteshypertensionmortality

Identifiers

PMID33825813
PMCPMC8351510

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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.