Evidence map›Paper›PMID 36227718›Full record

ArticleAmerican journal of hypertension2023

Influence of Baseline Diastolic Blood Pressure on the Effects of Systolic Blood Pressure Lowering on Cognitive Function in Type 2 Diabetes Mellitus.

Aditi Gupta, Robert Boucher, Guo Wei, Gary Gronseth, Adam Parks, Srinivasan Beddhu

Registry-linked trialOpen access · bronzeAbstract read
In one paragraph

Article in American journal of hypertension, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00000620. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 47% 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.

NCT00000620 phase3completed

Action to Control Cardiovascular Risk in Diabetes (ACCORD)

Ran1999Enrolled10,251Registered outcomes6Posted comparisons6ConditionsAtherosclerosis, Cardiovascular Diseases, Coronary Disease, Diabetes MellitusArmsAnti-hyperglycemic Agents, Anti-hypertensive Agents, Blinded fenofibrate or placebo plus simvastatin
Open the trial in the graph
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

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

6 authors at 2 institutions in 1 country.

Aditi GuptaDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.ORCID 0000-0002-6286-802X
Robert BoucherDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Guo WeiDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Gary GronsethDepartment of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Adam ParksDepartment of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Srinivasan BeddhuDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
University of Kansas Medical Center · USUniversity of Utah · US

Funding

Remote Monitoring and Virtual Collaborative Care for Hypertension Control to Prevent Cognitive DeclineR33AG068483 · NIA · UNIVERSITY OF KANSAS MEDICAL CENTER · PI BURNS, JEFFREY MURRAY, GUPTA, ADITI · 2021 to 2024
$11.4M
Objectively Measured Sedentary Behavior and Physical Activity in PREVENTABLE StudyR01AG074592 · NIA · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI BEDDHU, SRINIVASAN · 2021 to 2025
$3.4M
Sit Less, Interact and Move More (SLIMM) 2 StudyR01DK128640 · NIDDK · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI BEDDHU, SRINIVASAN · 2021 to 2025
$3.3M
Cognitive Impairment in End Stage Renal DiseaseK23AG055666 · NIA · UNIVERSITY OF KANSAS MEDICAL CENTER · PI GUPTA, ADITI · 2017 to 2022
$1.2M
Long-term metabolic effects of kidney events with intensive SBP controlR01DK118219 · NIDDK · UNIVERSITY OF UTAH · PI BEDDHU, SRINIVASAN, CHERTOW, GLENN MATTHEW · 2018 to 2021
$1.2M
NIA NIH HHS K23 AG055666NIA NIH HHS R01 AG074592NIA NIH HHS R33 AG068483NIDDK NIH HHS R01 DK118219NIDDK NIH HHS R01 DK128640
6 · The paper itself

Abstract

backgroundLowering of systolic blood pressure (SBP) in patients with low diastolic blood pressure (DBP), can further lower DBP. This can potentially decrease cerebral perfusion and cognition. We examined the influence of baseline DBP on the effect of lowering SBP on cognition.

methodsThis is a post hoc analysis of the Memory in Diabetes (MIND) substudy (N = 1,430) of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study (NCT00000620). Standard neuropsychological tests (Digit Symbol Substitution Test [DSST], Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [RAVLT], and Stroop test) were performed at baseline and months 20 and 40. We compared the effects of intensive (goal SBP <120 mm Hg) vs. standard (goal SBP <140 mm Hg) SBP control on the changes in the 4 test scores from baseline to the averages of months 20 and 40 across the range of baseline DBP using cubic spline terms.

resultsMean age was 63 ± 6 years, 55% were women and 66% White. Participates with lower baseline DBP were older, had more cardiovascular events and a longer duration of diabetes. There was no difference in the change in DSST (-0.22; 95% CI -0.97, 0.52), MMSE (-0.14; 95% CI -0.34, 0.06), RAVLT (-0.12; 95% CI -0.29, 0.06), and Stroop interference (-0.47; 95% CI -1.76, 0.82) in the intensive vs. standard SBP intervention. There was no interaction between baseline DBP and change in scores with the SBP intervention.

conclusionsIntensive SBP reduction does not adversely affect cognition, even in those with low baseline DBP.

Indexed as

Diabetes Mellitus, Type 2HypertensionHypotensionAgedBlood PressureCognitionFemaleHumansMaleMental Status and Dementia TestsMiddle AgedNeuropsychological Testsblood pressurecognitiondiabetesdiastolic blood pressurehypertension

Identifiers

PMID36227718
PMCPMC9922945
OpenAlexW4305014056

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.