Evidence mapPaperPMID 22080225Full record

ArticleJournal of hypertension2012

Microalbuminuria breakthrough under chronic renin-angiotensin-aldosterone system suppression.

Cesar Cerezo, Luis M Ruilope, Julian Segura, Jose A Garcia-Donaire, Juan J de la Cruz, Jose R Banegas, Bernard Waeber, Ton J Rabelink, Franz H Messerli

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of hypertension, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03887416 (Effect of Dapagliflozin on Nighttime Blood Pressure in Type 2 Diabetes), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing 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.

NCT03887416 phase4unknown statusstarted 2019, after this paper: background citation

Effect of Dapagliflozin on Nighttime Blood Pressure in Type 2 Diabetes

Ran2019Enrolled225Registered outcomes4Posted comparisons0ConditionsType2 DiabetesArmsDapagliflozin 10 MG Oral Tablet [Farxiga], Placebo Oral Tablet
Open the trial in the graph
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Efficacy of single-pill perindopril/indapamide in patients with hypertension and type 2 diabetes.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2014
    Trial
  3. ABCDE to identify and prevent chronic kidney disease: a call to action.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Article
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  11. The necessity and effectiveness of mineralocorticoid receptor antagonist in the treatment of diabetic nephropathy.Hypertension research : official journal of the Japanese Society of Hypertension · 2015
    Review
  12. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Cesar CerezoHypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
Luis M Ruilope
Julian Segura
Jose A Garcia-Donaire
Juan J de la Cruz
Jose R Banegas
Bernard Waeber
Ton J Rabelink
Franz H Messerli

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMicroalbuminuria has been shown to be a potent predictor for future development of cardiovascular and renal events that can be prevented by the use of angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs). Both classes of drugs are now-a-days widely used in the treatment of arterial hypertension since the very early stages of the cardiorenal continuum when only cardiovascular risk factors are detected. We describe here the development of de-novo microalbuminuria in patients chronically treated with either an ACEi or an ARB at adequate doses.

methodsWe reviewed the evolution of 1433 patients (mean age 60.5 ± 12.4 years, 50.3% men, 6.6% having type 2 diabetes), arriving in our hospital-based Hypertension Unit previously treated for a least 2 years either with an ACEi or an ARB, at adequate doses, alone or in combination with other antihypertensive drugs.

resultsA total of 184 (16.1%) patients developed new-onset microalbuminuria, whereas macroalbuminuria was detected in 11 (1.0%) patients at the end of follow-up. Albuminuria appeared at any level of blood pressure (BP) from below 130/80 mmHg, albeit the highest percentage was seen when SBP was above 160 mmHg. De-novo microalbuminuria was more frequent in those patients presenting with established cardiovascular disease and predicts the future development of cardiovascular events but was not accompanied by a significant worsening of renal function.

conclusionThese data indicate that a reappraisal of renin-angiotensin-aldosterone system (RAAS) suppression is required when microalbuminuria appears in patients under chronic RAAS suppression.

Indexed as

AgedAlbuminuriaFemaleHumansMaleMiddle AgedRenin-Angiotensin System

Identifiers

What Socratic holds

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Registered trials

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 Socratic graph.