Evidence mapPaperPMID 24779706Full record

Trial reportJournal of clinical hypertension (Greenwich, Conn.)2014

Impaired fasting glucose and body mass index as determinants of mortality in ALLHAT: is the obesity paradox real?

Ravi V Shah, Siddique A Abbasi, José-Miguel Yamal, Barry R Davis, Joshua Barzilay, Paula T Einhorn, Alison B Goldfine, Allison Goldfine, ALLHAT Collaborative Research Group

Erratum issuedOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical hypertension (Greenwich, Conn.), 2014. 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 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
1.4field-weighted citation impact, top 17% of its field
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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Obesity is bad regardless of the obesity paradox for hypertension and heart disease.Journal of clinical hypertension (Greenwich, Conn.) · 2018
    Article
  9. The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Review
  10. The obesity paradox: is it really a paradox? Hypertension.Eating and weight disorders : EWD · 2017
    Review
  11. The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2016
    Article
  12. Article
4 · The record

Corrections and comments

  • Erratum issued
    Goldfine, Allison [corrected to Goldfine, Alison B]
5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Ravi V ShahCardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA.
Siddique A Abbasi
José-Miguel Yamal
Barry R Davis
Joshua Barzilay
Paula T Einhorn
Alison B Goldfine
Allison Goldfine
ALLHAT Collaborative Research Group
The University of Texas at Austin · USBrigham and Women's Hospital · USJoslin Diabetes Center · USKaiser Permanente · USMassachusetts General Hospital · USNational Heart Lung and Blood Institute · US

Funding

CLINICAL TRIALS CENTER FOR ALLHAT-N01HC35130-268035130N01HC035130 · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 1993 to 2005
$6.3M
NHLBI NIH HHS HHSN268201100036CNHLBI NIH HHS N01 HC035130NHLBI NIH HHS N01-HC-35130
6 · The paper itself

Abstract

Emerging literature suggests that obesity may be "protective" against mortality and cardiovascular outcomes, while dysglycemia may worsen outcomes regardless of obesity. The authors measured the association of weight, smoking, and glycemia with mortality in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Among 5423 ALLHAT participants without established diabetes or cardiovascular disease, 3980 (73%) had normal fasting glucose and 1443 (27%) had impaired fasting glucose (IFG) levels at study entry. After a median of 4.9 years follow-up, 554 (10%) had died (37% cardiovascular). IFG was associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.02-1.50), while obesity was associated with lower all-cause mortality (adjusted HR, 0.76; 95% CI, 0.60-0.96). However, after excluding underweight individuals (body mass index [BMI] <22 kg/m(2) ) and smokers, neither obesity nor IFG was associated with all-cause mortality [corrected]. Although obesity appeared protective against mortality, this association was not significant in never-smokers or after exclusion of BMI <22 kg/m(2) . The obesity paradox may result from confounding by a sicker, underweight referent population and smoking.

Indexed as

Body Mass IndexAgedAntihypertensive AgentsBlood GlucoseCause of DeathDouble-Blind MethodFastingFemaleHumansHypertensionMaleMiddle AgedObesityPrognosisSurvival RateUnited StatesAntihypertensive AgentsBlood Glucose

Identifiers

PMID24779706
PMCPMC4091725
OpenAlexW2016195011

What Socratic holds

Textmetadata
LicenceTDM
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 Socratic graph.