Evidence map›Paper›PMID 39349379›Full record

ArticleBMJ open2024

Lifestyle approaches to hypertension for prevention of stroke and vascular cognitive impairment: a realist review protocol.

Sarah Ibrahim, Joanna Bielecki, Emine Kocabas, Sanjula Singh, Jasper R Senff, Leanne K Casaubon, Jonathan Rosand, Valeria E Rac, Aleksandra Pikula

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Advancing Ischemic Stroke Prognosis: Key Role of MiR-155 Non-Coding RNA.International journal of molecular sciences · 2025
    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

9 authors.

Sarah IbrahimInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-3750-2384
Joanna BieleckiToronto Health Economics and Health Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada.
Emine KocabasJay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Toronto, Ontario, Canada.
Sanjula SinghHenry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jasper R SenffHenry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Leanne K CasaubonDepartment of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.
Jonathan RosandHenry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Valeria E RacInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Aleksandra PikulaJay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Toronto, Ontario, Canada aleksandra.pikula@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionStroke and vascular cognitive impairment (VCI) are major global public health pandemics. The increased incidence of stroke and VCI is in part due to modifiable risk factors (MRFs), with hypertension (HTN) being the strongest single MRF. Even though the underlying causes of HTN are multifactorial, lifestyle choices (eg, poor diet, physical inactivity, alcohol consumption) are chief contributors. Lifestyle medicine (LSM) is a medical and evidence-based discipline that is a promising approach for preventing stroke and cognitive impairment, including VCI. The empirical evidence from systematic reviews, meta-analyses and large population-based studies has reported on the effectiveness of LSM interventions. However, the evaluation of such complex, social and behavioural interventions warrants more information to allow its successful implementation into innovative clinical care models. More importantly, we need to understand how such interventions work, who it works for and under what circumstances to successfully manage HTN and other MRFs (eg, hyperlipidaemia, smoking, alcohol use and diet). METHODS AND ANALYSIS: This realist review will follow the Realist and Meta-narrative Evidence Synthesis: Evolving Standards. The review will comprise four stages: (1) clarify the scope, (2) search for the evidence, (3) critically appraise primary studies and extract data focusing on the context, mechanism and outcome configuration and (4) synthesise evidence and draw conclusions. ETHICS AND DISSEMINATION: Research ethics board approval is not required for this review. The primary output of this review will be an evidence-based programme theory for LSM interventions for the management of HTN and other MRFs to reduce the risk of stroke and VCI. Findings from this review will be disseminated at three levels: micro (eg, patients, caregivers, clinicians, non-research partners), meso (eg, public, national not-for-profit organisations, professional associations and centres) and macro (eg, policymakers and government partners). PROSPERO REGISTRATION NUMBER: CRD42024511566.

Indexed as

Cognitive DysfunctionHypertensionLife StyleStrokeHumansResearch DesignRisk FactorsSystematic Reviews as TopicDementiaHypertensionPrimary PreventionStroke

Identifiers

PMID39349379
PMCPMC11448177

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.