Evidence map›Paper›PMID 34076333›Full record

Trial reportJournal of clinical hypertension (Greenwich, Conn.)2021

Monotherapy treatment with chlorthalidone or amlodipine in the systolic blood pressure intervention trial (SPRINT).

Deep Vakil, Stavros Zinonos, John B Kostis, Jeanne M Dobrzynski, Nora M Cosgrove, Abel E Moreyra, William J Kostis

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical hypertension (Greenwich, Conn.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 40% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. 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 at 1 institution in 1 country.

Deep VakilCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.ORCID 0000-0003-4799-6557
Stavros ZinonosCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
John B KostisCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.ORCID 0000-0002-0335-3827
Jeanne M DobrzynskiCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Nora M CosgroveCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Abel E MoreyraCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
William J KostisCardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.ORCID 0000-0002-0543-9798
Rutgers, The State University of New Jersey · US

Funding

NHLBI NIH HHS HHSN268200900049CNIDDK NIH HHSNIH HHS A-HL-13-002-001NIH HHS HHSN268200900040CNIH HHS HHSN268200900046CNIH HHS HHSN268200900047CNIH HHS HHSN268200900048CNIH HHS HHSN268200900049C
6 · The paper itself

Abstract

This post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) examined the performance of chlorthalidone (C) versus amlodipine (A) monotherapies. ANOVA was used to analyze the differences in systolic blood pressure (SBP) response between C and A. Logistic regression was used to examine monotherapy failure (adding a second antihypertensive agent or switching to a different antihypertensive agent) rates. Four hundred ninety-one participants were treated with C monotherapy (n = 210, mean dose = 22 mg/day) or A monotherapy (n = 281, mean dose = 7 mg/day). There was a significant difference in mean SBP reduction between the C and A monotherapies at the third visit (higher reduction with A, adjusted p = .018). Unadjusted analysis showed a higher failure with C in the standard treatment group. Although the average SBP at failure was higher and above the 140 mm Hg cutoff that indicated monotherapy failure with A (142.60) compared with C (138.40), more participants on C failed despite having SBP below the 140 cutoff. This was probably due to decisions made by the investigative teams to change the antihypertensive regimen, because, in their opinion, the clinical picture required it. After adjusting for baseline characteristics, C had higher failure than A only in the standard treatment group (1.64 odds ratio [OR], 95% CI 1.06-2.56, p = .028). A sub-analysis including participants who had never used antihypertensive treatment before randomization had similar results (2.57 OR, 95% CI 1.34-5.02, p = .004). Overall, in SPRINT chlorthalidone was associated with higher monotherapy failure than amlodipine in the standard treatment group because of decisions of the investigative teams.

Indexed as

ChlorthalidoneHypertensionAmlodipineAntihypertensive AgentsBlood PressureHumansTreatment OutcomeAmlodipineAntihypertensive AgentsChlorthalidoneamlodipinechlorthalidonehypertensionmonotherapySPRINT

Identifiers

PMID34076333
PMCPMC8678684
OpenAlexW3165573202

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.