Evidence map›Paper›PMID 33186448›Full record

Trial reportAmerican journal of hypertension2021

The Association of Orthostatic Hypotension With Ambulatory Blood Pressure Phenotypes in SPRINT.

Lama Ghazi, Paul E Drawz, Nicholas M Pajewski, Stephen P Juraschek

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of hypertension, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03569020 (Dietary Approaches to Stop Hypertension), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.0field-weighted citation impact, top 12% 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.

NCT03569020 nacompletednot on this map

Dietary Approaches to Stop Hypertension (DASH) Diet Effects on Serum Uric Acid (SUA) in Adults With Hyperuricemia and Gout

TypeinterventionalSponsorJohns Hopkins UniversityRan2018 to 2019Enrolled43ConditionsGout, HyperuricemiaArmsSubsidy for food purchases and dietitian education
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
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  3. Observational
  4. Article
  5. Review
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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

4 authors at 4 institutions in 1 country.

Lama GhaziYale University, School of Medicine, Clinical and Translational Research Accelerator, New Haven, Connecticut, USA.
Paul E DrawzUniversity of Minnesota Medical School, Department of Medicine, Division of Nephrology and Hypertension, Minneapolis, Minnesota, USA.
Nicholas M PajewskiWake Forest School of Medicine, Department of Biostatistics and Data Science, Winston-Salem, North Carolina, USA.
Stephen P JuraschekBeth Israel Deaconess Medical Center, Harvard Medical School, Department of Medicine, Division of General Medicine, Boston, Massachusetts, USA.ORCID 0000-0003-4168-2696
Beth Israel Deaconess Medical Center · USUniversity of Minnesota Medical Center · USWake Forest University · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
The SPRINT Alzheimer's, Seniors and Kidney Study (SPRINT ASK)R01AG055606 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI REBOUSSIN, DAVID M, WILLIAMSON, JEFF DOUGLAS · 2017 to 2023
$9.9M
Blood Pressure and Kidney Function - SPRINT vs Electronic Health Record DataR01HL136679 · NHLBI · UNIVERSITY OF MINNESOTA · PI DRAWZ, PAUL ENGLUND · 2017 to 2021
$3.8M
Vitamin D, Subclinical Cardiovascular Disease, and Orthostatic Hypotension in Older AdultsK23HL135273 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI JURASCHEK, STEPHEN P · 2017 to 2021
$1.1M
Ambulatory Blood Pressure and Cognitive Function in the Systolic Blood Pressure Intervention TrialR03DK105314 · NIDDK · VETERANS MEDICAL RESEARCH FDN/SAN DIEGO · PI RIFKIN, DENA EVETTE · 2015 to 2016
$179k
Effect of Standard vs Intense Hypertension Management on Nighttime Blood PressureR03DK100530 · NIDDK · UNIVERSITY OF MINNESOTA · PI DRAWZ, PAUL ENGLUND · 2014 to 2015
$152k
NCATS NIH HHS UL1 TR001863NCATS NIH HHS UL1 TR003142NHLBI NIH HHS HHSN268200900040CNHLBI NIH HHS HHSN268200900046CNHLBI NIH HHS HHSN268200900047CNHLBI NIH HHS HHSN268200900048CNHLBI NIH HHS HHSN268200900049CNHLBI NIH HHS K23 HL135273NHLBI NIH HHS R01 HL136679NIA NIH HHS R01 AG055606NIDDK NIH HHS R03 DK100530NIDDK NIH HHS R03 DK105314
6 · The paper itself

Abstract

backgroundClinic blood pressure (BP) when measured in the seated position, can miss meaningful BP phenotypes, including low ambulatory BP (white coat effects [WCE]) or high supine BP (nocturnal non-dipping). Orthostatic hypotension (OH) measured using both seated (or supine) and standing BP, could identify phenotypes poorly captured by seated clinic BP alone.

methodsWe examined the association of OH with WCE and night-to-daytime systolic BP (SBP) in a subpopulation of SPRINT, a randomized trial testing the effects of intensive or standard (<120 vs. <140 mm Hg) SBP treatment strategies in adults at increased risk of cardiovascular disease. OH was assessed during follow-up (6, 12, and 24 months) and defined as a decrease in mean seated SBP ≥20 or diastolic BP ≥10 mm Hg after 1 min of standing. WCE, based on 24-hour ambulatory BP monitoring performed at 27 months, was defined as the difference between 27-month seated clinic and daytime ambulatory BP ≥20/≥10 mm Hg. Reverse dipping was defined as a ratio of night-to-daytime SBP >1.

resultsOf 897 adults (mean age 71.5±9.5 years, 29% female, 28% black), 128 had OH at least once. Among those with OH, 15% had WCE (vs. 7% without OH). Moreover, 25% of those with OH demonstrated a non-dipping pattern (vs. 14% without OH). OH was positively associated with both WCE (OR=2.24; 95%CI: 1.28, 4.27) and reverse dipping (OR=2.29; 95% CI: 1.31, 3.99).

conclusionsThe identification of OH in clinic was associated with two BP phenotypes often missed with traditional seated BP assessments. Further studies on mechanisms of these relationships are needed. CLINICAL TRIALS REGISTRATION: Trial Number NCT03569020.

Indexed as

Blood Pressure Monitoring, AmbulatoryHypotension, OrthostaticPhenotypeAgedAged, 80 and overFemaleHumansMaleMiddle Agedambulatory blood pressure monitoringblood pressurehypertensionnocturnal dipping statusorthostatic hypotensionwhite coat effects

Identifiers

PMID33186448
PMCPMC8140655
OpenAlexW3105830913

What Socratic holds

Textmetadata
Read underepoch 390

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.