Evidence map›Paper›PMID 35385506›Full record

ArticlePloS one2022

Blood pressure response to commonly administered antihypertensives for severe inpatient hypertension.

Lama Ghazi, Fan Li, Xinyuan Chen, Michael Simonov, Yu Yamamoto, Aditya Biswas, Jonathan Hanna, Tayyab Shah, Aldo J Peixoto, F Perry Wilson

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. 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
1.5field-weighted citation impact, top 17% 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, 10 citations in OpenAlex.

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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

10 authors at 3 institutions in 1 country.

Lama GhaziDepartment of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, United States of America.ORCID 0000-0002-9930-3575
Fan LiDepartment of Biostatistics, Yale School of Public Health, New Haven, CT, United States of America.ORCID 0000-0001-6183-1893
Xinyuan ChenDepartment of Mathematics and Statistics, Mississippi State University, Mississippi State, MS, United States of America.ORCID 0000-0002-6127-9602
Michael SimonovDepartment of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, United States of America.
Yu YamamotoDepartment of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, United States of America.
Aditya BiswasDepartment of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, United States of America.
Jonathan HannaDepartment of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, United States of America.
Tayyab ShahDepartment of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, United States of America.
Aldo J PeixotoDepartment of Internal Medicine, Section of Nephrology, Yale School of Medicine, and the Hypertension Program, Yale New Haven Hospital Heart and Vascular Center, New Haven, CT, United States of America.
F Perry WilsonDepartment of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, United States of America.
Yale University · USMississippi State University · USYale New Haven Hospital · US

Funding

Renal Physiology and Phenotyping CoreP30DK079310 · NIDDK · YALE UNIVERSITY · PI ARONSON, PETER S. · 2008 to 2022
$16.8M
Optimizing Electronic Alerts for Acute Kidney InjuryR01DK113191 · NIDDK · YALE UNIVERSITY · PI WILSON, FRANCIS PERRY · 2018 to 2022
$3.1M
Personalized Recommendations for Acute Kidney Injury (AKI) Care Using a Kidney Action Team: A Randomized TrialR01HS027626 · AHRQ · YALE UNIVERSITY · PI WILSON, FRANCIS PERRY · 2021 to 2025
$1.9M
AHRQ HHS R01 HS027626NIDDK NIH HHS P30 DK079310NIDDK NIH HHS R01 DK113191
6 · The paper itself

Abstract

backgroundBlood pressure (BP) elevations are commonly treated in hospitalized patients; however, treatment is not guideline directed. Our objective was to assess BP response to commonly prescribed antihypertensives after the development of severe inpatient hypertension (HTN).

methodsThis is a cohort study of adults, excluding intensive care unit patients, within a single healthcare system admitted for reasons other than HTN who developed severe HTN (systolic BP>180 or diastolic BP >110 mmHg at least 1 hour after admission). We identified the most commonly administered antihypertensives given within 6 hours of severe HTN (given to >10% of treated patients). We studied the association of treatment with each antihypertensive vs. no treatment on BP change in the 6 hours following severe HTN development using mixed-effects model after adjusting for demographics and clinical characteristics.

resultsAmong 23,147 patients who developed severe HTN, 9,166 received antihypertensive treatment. The most common antihypertensives given were oral metoprolol (n = 1991), oral amlodipine (n = 1812), oral carvedilol (n = 1116), IV hydralazine (n = 1069) and oral hydralazine (n = 953). In the fully adjusted model, treatment with IV hydralazine led to 13 [-15.9, -10.1], 18 [-22.2, -14] and 11 [-14.1, -8.3] mmHg lower MAP, SBP, and DBP in the 6 hours following severe HTN development compared to no treatment. Treatment with oral hydralazine and oral carvedilol also resulted in significantly lower BPs in the 6 hours following severe HTN development (6 [-9.1, -2.1 and -7 [-9.1, -4.2] lower MAP, respectively) compared to no treatment. Receiving metoprolol and amlodipine did not result in a drop in BP compared to no treatment.

conclusionAmong commonly used antihypertensives, IV hydralazine resulted in the most significant drop in BP following severe HTN, while metoprolol and amlodipine did not lower BP. Further research to assess the effect of treatment on clinical outcomes and if needed which antihypertensives to administer are necessary.

Indexed as

Antihypertensive AgentsHypertensionAdultAmlodipineBlood PressureCarvedilolCohort StudiesHumansHydralazineInpatientsMetoprololAmlodipineAntihypertensive AgentsCarvedilolHydralazineMetoprolol

Identifiers

PMID35385506
PMCPMC8985959
OpenAlexW4226062741

What OpenQuestion holds

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LicenceCC BY
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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.