Evidence map›Paper›PMID 38362733›Full record

Trial reportAnnals of neurology2024

Intensive Blood Pressure Treatment and Subclinical Brain Infarcts: A Secondary Analysis of SPRINT (Systolic Pressure Intervention Trial).

Kyle C Kern, Ilya M Nasrallah, R Nick Bryan, Jeff Williamson, David M Reboussin, Nicholas M Pajewski, Clinton B Wright

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Annals of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 21% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Systolic blood pressure and future stroke risk by asymptomatic brain lesions in a community MRI cohort: a retrospective study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  3. Review
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 3 institutions in 1 country.

Kyle C KernStroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.ORCID 0000-0002-2703-7669
Ilya M NasrallahDepartment of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
R Nick BryanDepartment of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jeff WilliamsonDepartment of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
David M ReboussinDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Nicholas M PajewskiDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Clinton B WrightStroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
Wake Forest University · USNational Institutes of Health · USUniversity of Pennsylvania · US

Funding

INSTITUTIONAL CLINICAL AND TRANSLATIONAL SCIENCE AWARDUL1RR024134 · NCRR · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2006 to 2011
$70.4M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Tufts Clinical and Translational Research InstituteUL1TR001064 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$26.4M
University of Iowa Clinical and Translational Science Program (TL1)UL1RR025755 · NCRR · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2008 to 2011
$26.3M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025771 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI CENTER, DAVID M. · 2008 to 2011
$17.6M
TUFTS CLINICAL AND TRANSLATION SCIENCE INSTITUTE (UL1): BPCAUL1RR025752 · NCRR · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2008 to 2011
$17.6M
Clinical and Translational Science Institute at Children's NationalUL1TR000075 · NCATS · CHILDREN'S RESEARCH INSTITUTE · PI GUAY-WOODFORD, LISA MARIE · 2012 to 2015
$13.7M
Intramural NIH HHS Z99 NS999999NCATS NIH HHS U54TR000017-06NCATS NIH HHS UL1RR024134NCATS NIH HHS UL1RR025752NCATS NIH HHS UL1RR025755NCATS NIH HHS UL1RR025771NCATS NIH HHS UL1TR000002NCATS NIH HHS UL1TR000003NCATS NIH HHS UL1 TR000005NCATS NIH HHS UL1TR000005NCATS NIH HHS UL1 TR000050NCATS NIH HHS UL1TR000050NCATS NIH HHS UL1TR000064NCATS NIH HHS UL1TR000073NCATS NIH HHS UL1 TR000075NCATS NIH HHS UL1TR000075NCATS NIH HHS UL1 TR000093NCATS NIH HHS UL1TR000093NCATS NIH HHS UL1TR000105-05NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1TR000433NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1TR000439NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1TR000445NCATS NIH HHS UL1 TR001064NCATS NIH HHS UL1TR001064NCATS NIH HHS UL1 TR003142NCRR NIH HHS UL1 RR024134NCRR NIH HHS UL1 RR025752NCRR NIH HHS UL1 RR025755NCRR NIH HHS UL1 RR025771NIA NIH HHS R01 AG055606NIA NIH HHS R01 AG065805NIDDK NIH HHSNIGMS NIH HHS P30 GM103337NIGMS NIH HHS P30GM103337NIH HHS A-HL-13-002-001NINDS NIH HHS
6 · The paper itself

Abstract

objectiveSubclinical brain infarcts (SBI) increase the risk for stroke and dementia, but whether they should be considered equivalent to symptomatic stroke when determining blood pressure targets remains unclear. We tested whether intensive systolic blood pressure (SBP) treatment reduced the risk of new SBI or stroke and determined the association between SBI and cognitive impairment.

methodsIn this secondary analysis of SPRINT (Systolic Pressure Intervention Trial), participants ≥50 years old, with SBP 130-180mmHg and elevated cardiovascular risk but without known clinical stroke, dementia, or diabetes, were randomized to intensive (<120mmHg) or standard (<140mmHg) SBP treatment. Brain magnetic resonance images collected at baseline and follow-up were read for SBI. The occurrence of mild cognitive impairment (MCI) or probable dementia (PD) was evaluated.

resultsFor 667 participants at baseline, SBI were identified in 75 (11%). At median 3.9 years follow-up, 12 of 457 had new SBI on magnetic resonance imaging (5 intensive, 7 standard), whereas 8 had clinical stroke (4 per group). Baseline SBI (subhazard ratio [sHR] = 3.90; 95% CI 1.49 to 10.24; p = 0.006), but not treatment group, was associated with new SBI or stroke. For participants with baseline SBI, intensive treatment reduced their risk for recurrent SBI or stroke (sHR = 0.050; 95% CI 0.0031 to 0.79; p = 0.033). Baseline SBI also increased risk for MCI or PD during follow-up (sHR = 2.38; 95% CI 1.23 to 4.61; p = 0.010).

interpretationNew cerebral ischemic events were infrequent, but intensive treatment mitigated the increased risk for participants with baseline SBI, indicating primary prevention SBP goals are still appropriate when SBI are present. ANN NEUROL 2024;95:866-875.

Indexed as

Antihypertensive AgentsBrain InfarctionCognitive DysfunctionAgedBlood PressureDementiaFemaleHumansHypertensionMagnetic Resonance ImagingMaleMiddle AgedStrokeAntihypertensive Agents

Identifiers

PMID38362733
PMCPMC11060925
OpenAlexW4391893280

What OpenQuestion holds

Textmetadata
LicenceTDM
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.