Evidence map›Paper›PMID 41948811›Full record

Trial reportBritish journal of clinical pharmacology2026

Sequential nephron blockade vs. sequential renin-angiotensin system blockade on central and ambulatory blood pressure in resistant hypertension: A randomized clinical trial.

Juan Carlos Yugar-Toledo, Tatiana Palotta Minari, Priscilla Galisteu de Mello, Elizabeth do Espirito Santo Cestario, Tatiane de Azevedo Rubio, Larissa Morete Caieiro da Costa, Louise Buonalumi Tácito Yugar, Luis Gustavo Sedenho-Prado, Lúcia Helena Bonalume Tacito, Luciana Neves Cosenso-Martin and 4 more

Erratum issuedAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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. Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Juan Carlos Yugar-ToledoHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Tatiana Palotta MinariHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.ORCID https://orcid.org/0000-0003-2008-9287
Priscilla Galisteu de MelloHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Elizabeth do Espirito Santo CestarioHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Tatiane de Azevedo RubioFaculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
Larissa Morete Caieiro da CostaHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Louise Buonalumi Tácito YugarFaculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
Luis Gustavo Sedenho-PradoFaculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
Lúcia Helena Bonalume TacitoEndocrinology Division of the Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São Paulo, Brazil.
Luciana Neves Cosenso-MartinHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
André FattoriFaculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
Luciana Pellegrini PisaniDepartment of Bioscience, Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil.
José Fernando Vilela-MartinHypertension Clinic, Department of Internal Medicine, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Heitor MorenoFaculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThis study compares sequential nephron blockade (SNB) and renin-angiotensin system sequential blockade (RASSB) in patients with resistant hypertension (RHTN), evaluating central systolic pressure, arterial stiffness, pulse pressure and ambulatory blood pressure monitoring (ABPM).

methodsA total of 72 patients with resistant hypertension were recruited from the Hypertension Outpatient Clinic and randomly allocated to two treatment groups: SNB (n = 35; 22 women, 13 men) and RASSB (n = 37; 22 women, 15 men). Central systolic blood pressure (CSBP), augmentation index (AI) and AI75 were assessed using validated non-invasive tonometry. ABPM was performed over 24 h to evaluate systolic, diastolic and pulse pressure changes.

resultsOffice blood pressure reductions were significant in both groups (p < .0001). SNB: SBP from 174.5 to 127.0 mmHg; DBP from 105.3 to 78.11 mmHg. RASSB: SBP from 178.4 to 134.4 mmHg; DBP from 102.7 to 77.33 mmHg. ABPM confirmed 24-h reductions (p < .0001). SNB showed greater pulse pressure reduction (Δ = 22.99 vs. 15.93 mmHg, p = .024) and central systolic pressure reduction (Δ = -10.3 vs. -5.1 mmHg, p = .036). RASSB elicited a significant decrease in heart rate (Δ = -12.4 bpm, p < .0001). No treatment-related discontinuations occurred.

conclusionSNB demonstrated superior efficacy in reducing CSBP and pulse pressure, while RASSB more effectively lowered heart rate. These distinct haemodynamic responses support individualized treatment strategies for patients with RHTN.

Indexed as

Angiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBlood PressureHypertensionNephronsRenin-Angiotensin SystemAgedBlood Pressure Monitoring, AmbulatoryDrug ResistanceFemaleHumansMaleMiddle AgedTreatment OutcomeVascular StiffnessAngiotensin-Converting Enzyme InhibitorsAntihypertensive Agentsambulatory blood pressure monitoringarterial stiffnessbisoprololnatriuretic agentspulse pressurerenin–angiotensin systemresistant hypertension

Identifiers

PMID41948811
PMCPMC13421060

What OpenQuestion holds

Textmetadata
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.