Evidence map›Paper›PMID 41130973›Full record

ArticleNature communications2025

Predicting hypotension, syncope, and fracture risk in patients indicated for antihypertensive treatment: the STRATIFY models.

Constantinos Koshiaris, Ariel Wang, Lucinda Archer, Richard D Riley, Kym Ie Snell, Richard J Stevens, Amitava Banerjee, Subhashisa Swain, Andrew Clegg, Christopher E Clark and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

16 authors.

Constantinos KoshiarisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. koshiaris.c@unic.ac.cy.ORCID http://orcid.org/0000-0002-9821-7608
Ariel WangNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-5360-9993
Lucinda ArcherDepartment of Applied Health Sciences, The University of Birmingham, Birmingham, UK.
Richard D RileyDepartment of Applied Health Sciences, The University of Birmingham, Birmingham, UK.
Kym Ie SnellDepartment of Applied Health Sciences, The University of Birmingham, Birmingham, UK.
Richard J StevensNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-9258-4060
Amitava BanerjeeInstitute of Health Informatics, University College London, London, UK.ORCID http://orcid.org/0000-0001-8741-3411
Subhashisa SwainNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Andrew CleggAcademic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, University of Leeds, Leeds, UK.
Christopher E ClarkExeter Collaboration for Academic Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Rd, Exeter, UK.ORCID http://orcid.org/0000-0002-7526-3038
Rupert A PayneExeter Collaboration for Academic Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Rd, Exeter, UK.ORCID http://orcid.org/0000-0002-5842-4645
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-7976-7172
Margaret OgdenPatient and Public Advisor, Durham, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-3638-028X
James P SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. james.sheppard@phc.ox.ac.uk.ORCID http://orcid.org/0000-0002-4461-8756
STRATIFY investigators

Funding

DH | National Institute for Health Research (NIHR) project 430Wellcome Trust (Wellcome) 211182/Z/18/Z
6 · The paper itself

Abstract

Antihypertensives are associated with increased risk of syncope, hypotension, and fractures, but the highest-risk individuals are unclear. This study aimed to develop and validate three models to predict these outcomes in patients with an indication for antihypertensive treatment. A cohort study was conducted using data from Clinical Practice Research Datalink (CPRD). Patients aged 40+ with systolic blood pressure 130-179 mmHg were included. Outcomes were first hypotension, syncope, or fracture leading to hospitalization or death within 10 years. Models were derived from CPRD GOLD data (n = 1,773,224) and validated with CPRD Aurum data (n = 3,805,366). Each model had 31-37 predictors. Validation demonstrated strong discriminative ability (10-year C-statistic: hypotension 0.824; syncope 0.819; fracture 0.790), with close agreement between predicted and observed risks for the hypotension and syncope models. Some underprediction was observed for the fracture model. These models could be used to help reassure patients about the relatively low risk of harm from antihypertensive treatment, or identify the small number of individuals with a higher risk where additional monitoring may be indicated.

Indexed as

Antihypertensive AgentsFractures, BoneHypertensionHypotensionSyncopeAdultAgedBlood PressureCohort StudiesFemaleHumansMaleMiddle AgedRisk AssessmentRisk FactorsAntihypertensive Agents

Identifiers

PMID41130973
PMCPMC12550095

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Registered trials

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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.