Evidence map›Paper›PMID 37877683›Full record

SynthesisEuropean journal of neurology2024

Risk of subarachnoid haemorrhage reduces with blood pressure values below hypertensive thresholds.

Frederick Ewbank, Benjamin Gaastra, Samuel Hall, Ian Galea, Diederik Bulters

Open access · hybridAbstract readMeta-Analysis
In one paragraph

Synthesis in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 19% 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, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. 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

5 authors at 2 institutions in 1 country.

Frederick EwbankDepartment of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID 0000-0003-3969-5199
Benjamin GaastraDepartment of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Samuel HallDepartment of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Ian GaleaFaculty of Medicine, University of Southampton, Southampton, UK.ORCID 0000-0002-1268-5102
Diederik BultersDepartment of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
University Hospital Southampton NHS Foundation Trust · GBUniversity of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension is a known risk factor for subarachnoid haemorrhage (SAH). The aim of this study was to describe the relationship between blood pressure and SAH using a large cohort study and perform a meta-analysis of the published literature.

methodsParticipants in the UK Biobank were followed up via electronic records until 31 March 2017. Cox proportional hazards models were used to analyse the association between baseline blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP] and MABP [mean arterial blood pressure]) and subsequent aneurysmal SAH. Linearity was assessed by comparing models including and excluding cubic splines. Electronic databases were searched from inception until 11 February 2022 for studies reporting on blood pressure and SAH.

resultsA total of 500,598 individuals were included with 539 (0.001%) suffering from aneurysmal SAH. Nonlinear models including cubic splines visually appeared linear between SBP of 110 and 180 mmHg and there was minimal difference in fit between linear and nonlinear models. When values were stratified, those with SBP 120-130 mmHg were at higher risk compared to those with SBP <120 mmHg (hazard ratio [HR] 1.41 [1.02, 1.95]). The meta-analysis demonstrated a similar increased risk of SAH in individuals with SBP 120-130 mmHg relative to those with <120 mmHg (HR 1.41 [1.17, 1.72]). A stepwise increase in risk was also seen at each subsequent threshold (130-140 mmHg: HR 1.85 [1.53, 2.24], 140-160 mmHg: HR 2.16 [1.57, 2.98], 160-180 mmHg: HR 2.81 [1.85, 4.29], >180 mmHg: HR 5.84 [1.94, 17.54]).

conclusionsThe rate of SAH increases linearly with higher SBP in the general population and specifically appears lower in those with SBP <120 mmHg.

Indexed as

HypertensionStrokeSubarachnoid HemorrhageBlood PressureCohort StudiesHumansRisk Factorsblood pressurehypertensionstrokesubarachnoid haemorrhage

Identifiers

PMID37877683
PMCPMC11236026
OpenAlexW4387931660

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.