Evidence map›Paper›PMID 38813695›Full record

ArticleCirculation. Cardiovascular quality and outcomes2024

Effect of Population-Level Blood Pressure Treatment Strategies on Cardiovascular and Cognitive Outcomes.

James F Burke, Jeremy B Sussman, Kristine Yaffe, Rodney A Hayward, Bruno J Giordani, Andrzej T Galecki, Rachael Whitney, Emily M Briceño, Alden L Gross, Mitchell S V Elkind and 5 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2024. 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
–field-weighted citation impact
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.

  1. Article
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

James F BurkeDepartment of Neurology, Ohio State University Wexner Medical Center, Columbus (J.F.B.).ORCID 0000-0002-2296-1588
Jeremy B SussmanDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0002-2158-3618
Kristine YaffeDepartments of Psychiatry, Neurology and Epidemiology (K.Y.), University of California, San Francisco.
Rodney A HaywardDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.
Bruno J GiordaniDepartment of Psychiatry and Michigan Alzheimer's Disease Center (B.J.G.), University of Michigan, Ann Arbor.ORCID 0000-0001-5921-3455
Andrzej T GaleckiDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0003-1542-4001
Rachael WhitneyDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.
Emily M BriceñoDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0002-9360-8917
Alden L GrossDepartment of Epidemiology, Johns Hopkins Bloomberg School Public Health, Baltimore, MD (A.L.G.).ORCID 0000-0002-4678-0562
Mitchell S V ElkindDepartment of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E., J.J.M.), Columbia University, New York, NY.ORCID 0000-0003-2562-1156
Jennifer J ManlyDepartment of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E., J.J.M.), Columbia University, New York, NY.ORCID 0000-0002-9481-7497
Rebecca F GottesmanStroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.F.G.).ORCID 0000-0002-9504-1256
Darrell J GaskinDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (D.J.G.).ORCID 0000-0002-0822-1583
Stephen SidneyKaiser Permanente Northern California Division of Research, Oakland (S.S.).ORCID 0009-0008-4556-6426
Deborah A LevineDepartment of Internal Medicine and Cognitive Health Services Research Program (J.B.S., R.A.H., A.T.G., R.W., E.M.B., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0002-6864-8001

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
STROKE INCIDENCE AND RISK FACTORS IN A TRI-ETHNIC REGIONR01NS029993 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ELKIND, MITCHELL S, SACCO, RALPH L. · 1993 to 2019
$19.2M
Task Area A Core Study Operations.Task Area A shall encompass annual follow-up of cohort members, clinical endpoints ascertainment, study coordination activities, maintenance of the database and biosp75N92020D00001 · NHLBI · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, ROBYN LEAGH · 2020 to 2025
$17.2M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
Michigan Alzheimer's Disease Core CenterP30AG053760 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ALBIN, ROGER L · 2016 to 2020
$10.1M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CARDIOVASCULAR HEALTH STUDY (CHS) - TASK AREA C, STUDY CLOSEOUT75N92021D00006 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE · 2021 to 2024
$8.4M
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6 · The paper itself

Abstract

backgroundThe large and increasing number of adults living with dementia is a pressing societal priority, which may be partially mitigated through improved population-level blood pressure (BP) control. We explored how tighter population-level BP control affects the incidence of atherosclerotic cardiovascular disease (ASCVD) events and dementia.

methodsUsing an open-source ASCVD and dementia simulation analysis platform, the Michigan Chronic Disease Simulation Model, we evaluated how optimal implementation of 2 BP treatments based on the Eighth Joint National Committee recommendations and SPRINT (Systolic Blood Pressure Intervention Trial) protocol would influence population-level ASCVD events, global cognitive performance, and all-cause dementia. We simulated 3 populations (usual care, Eighth Joint National Committee based, SPRINT based) using nationally representative data to annually update risk factors and assign ASCVD events, global cognitive performance scores, and dementia, applying different BP treatments in each population. We tabulated total ASCVD events, global cognitive performance, all-cause dementia, optimal brain health, and years lived in each state per population.

resultsOptimal implementation of SPRINT-based BP treatment strategy, compared with usual care, reduced ASCVD events in the United States by ≈77 000 per year and produced 0.4 more years of stroke- or myocardial infarction-free survival when averaged across all Americans. Population-level gains in years lived free of ASCVD events were greater for SPRINT-based than Eighth Joint National Committee-based treatment. Survival and years spent with optimal brain health improved with optimal SPRINT-based BP treatment implementation versus usual care: the average patient with hypertension lived 0.19 additional years and 0.3 additional years in optimal brain health. SPRINT-based BP treatment increased the number of years lived without dementia (by an average of 0.13 years/person with hypertension), but increased the total number of individuals with dementia, mainly through more adults surviving to advanced ages.

conclusionsTighter BP control likely benefits most individuals but is unlikely to reduce dementia prevalence and might even increase the number of older adults living with dementia.

Indexed as

Antihypertensive AgentsBlood PressureCognitionDementiaHypertensionAgedAged, 80 and overAtherosclerosisComputer SimulationFemaleHumansIncidenceMaleMichiganMiddle AgedRisk AssessmentAntihypertensive Agentsblood pressurecardiovascular diseasesdementiamyocardial infarctionstroke

Identifiers

PMID38813695
PMCPMC11187641

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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.