Evidence map›Paper›PMID 35058294›Full record

SynthesisHeart (British Cardiac Society)2022

Antihypertensive drug effects on long-term blood pressure: an individual-level data meta-analysis of randomised clinical trials.

Dexter Canoy, Emma Copland, Milad Nazarzadeh, Rema Ramakrishnan, Ana-Catarina Pinho-Gomes, Abdul Salam, Jamie P Dwyer, Farshad Farzadfar, Johan Sundström, Mark Woodward and 4 more

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Heart (British Cardiac Society), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 5 pooled it
8.9field-weighted citation impact, top 1% 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

43 citing papers in PubMed, 5 syntheses or guidelines pooled it, 58 citations in OpenAlex.

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  8. Durability of blood pressure reduction after ultrasound renal denervation: three-year follow-up of the treatment arm of the randomised RADIANCE-HTN SOLO trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022
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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

14 authors at 8 institutions in 7 countries.

Dexter CanoyDeep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-4493-9901
Emma CoplandDeep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-9280-5241
Milad NazarzadehDeep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-0576-8874
Rema RamakrishnanNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-6784-8319
Ana-Catarina Pinho-GomesSchool of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Abdul SalamThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Jamie P DwyerVanderbilt University Medical Center, Nashville, Tennessee, USA.
Farshad FarzadfarEndocrinology and Metabolism Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Johan SundströmDepartment of Medical Sciences, Uppsala Universitet, Uppsala, Sweden.ORCID http://orcid.org/0000-0003-2247-8454
Mark WoodwardThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9800-5296
Barry R DavisDepartment of Biostatistics, University of Texas School of Public Health, Houston, Texas, USA.
Kazem RahimiDeep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK kazem.rahimi@wrh.ox.ac.uk.ORCID http://orcid.org/0000-0002-4807-4610
Blood Pressure Lowering Treatment Trialists' Collaboration
Blood Pressure Lowering Treatment Trialists Collaboration
University of Oxford · GBTehran University of Medical Sciences · IRThe George Institute for Global Health · GBThe University of Texas Health Science Center at Houston · USUniversidade do Porto · PTUNSW Sydney · AUUppsala University · SEVanderbilt University Medical Center · US

Funding

British Heart Foundation FS/19/36/34346British Heart Foundation PG/18/65/33872
6 · The paper itself

Abstract

objectiveEvidence from randomised trials of pharmacological treatments on long-term blood pressure (BP) reduction is limited. We investigated the antihypertensive drug effects on BP over time and across different participant characteristics.

methodsWe conducted an individual patient-level data meta-analysis of 52 large-scale randomised clinical trials in the Blood Pressure Lowering Treatment Trialists' Collaboration using mixed models to examine treatment effects on BP over 4 years of mean follow-up.

resultsThere were 363 684 participants (42% women), with baseline mean age=65 years and mean systolic/diastolic BP=152/87 mm Hg, and among whom 19% were current smokers, 49% had cardiovascular disease, 28% had diabetes and 69% were taking antihypertensive treatment at baseline. Drugs were effective in lowering BP showing maximal effect after 12 months and gradually attenuating towards later years. Based on measures taken ≥12 months postrandomisation, mean systolic/diastolic BP difference (95% CI) between more and less intense BP-lowering treatment was -11.1 (-11.3 to -10.8)/-5.6 (-5.7 to -5.4) mm Hg; between active treatment and placebo was -5.1 (-5.3 to -5.0)/-2.3 (-2.4 to -2.2) mm Hg; and between active and control arms for drug comparison trials was -1.4 (-1.5 to -1.3)/-0.6 (-0.7 to -0.6) mm Hg. BP reductions were observed across different baseline BP values and ages, and by sex, history of cardiovascular disease and diabetes and prior antihypertensive treatment use.

conclusionThese findings suggest that BP-lowering pharmacotherapy is effective in lowering BP, up to 4 years on average, in people with different characteristics. Appropriate treatment strategies are needed to sustain substantive long-term BP reductions.

Indexed as

Cardiovascular DiseasesDiabetes MellitusHypertensionAgedAntihypertensive AgentsBlood PressureFemaleHumansMaleRandomized Controlled Trials as TopicAntihypertensive Agentsclinicalhypertensionmeta-analysispharmacology

Identifiers

PMID35058294
PMCPMC9340038
OpenAlexW4206415018

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.