Evidence mapPaperPMID 34022790Full record

Trial reportBMC cardiovascular disorders2021

High prevalence of non-dipping patterns among Black Africans with uncontrolled hypertension: a secondary analysis of the CREOLE trial.

Prossie Merab Ingabire, Dike B Ojji, Brian Rayner, Elijah Ogola, Albertino Damasceno, Erika Jones, Anastase Dzudie, Okechukwu S Ogah, Neil Poulter, Mahmoud U Sani and 10 more

Registry-linked trialOpen access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02742467 (Comparison of Three Combination Therapies in Lowering Blood Pressure in Black Africans), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 9% 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.

NCT02742467 phase4completednot on this map

Comparison of Three Combination Therapies in Lowering Blood Pressure in Black Africans

TypeinterventionalSponsorUniversity of AbujaRan2017 to 2018Enrolled702ConditionsHypertensionArmsPerindopril plus Amlodipine, Perindopril plus Hydrochlorothiazide, Amlodipine plus Hydrochlorothiazide
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Bedtime Versus Morning Dosing of Anti-hypertensives: A GRADE-Assessed Meta-Analysis of Randomized Controlled Trials with Trial Sequential Evidence.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
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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

20 authors at 12 institutions in 7 countries.

Prossie Merab IngabireSt. Francis Hospital, Nsambya, Kampala, Uganda. prossienkundiye@gmail.com.
Dike B OjjiDepartment of Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria.
Brian RaynerDivision of Nephrology and Hypertension, Cape Town, South Africa.
Elijah OgolaDepartment of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya.
Albertino DamascenoEduardo Mondlane University Hospital, Maputo, Mozambique.
Erika JonesDivision of Nephrology and Hypertension, Cape Town, South Africa.
Anastase DzudieDouala General Hospital, Douala, Cameroon.
Okechukwu S OgahCardiology Unit, Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Neil PoulterImperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK.
Mahmoud U SaniDepartment of Medicine, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.
Felix Ayub BarasaDepartment of Cardiology, Moi Teaching and Referral Hospital, Eldoret, Kenya.
Grace ShedulPharmacy, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
John MukisaMakNCD D43 Project, Makerere University College of Health Sciences, Kampala, Uganda.
David MukunyaMakNCD D43 Project, Makerere University College of Health Sciences, Kampala, Uganda.
Bonnie WanderaMakNCD D43 Project, Makerere University College of Health Sciences, Kampala, Uganda.
Charles BatteMakNCD D43 Project, Makerere University College of Health Sciences, Kampala, Uganda.
James KayimaMakNCD D43 Project, Makerere University College of Health Sciences, Kampala, Uganda.
Shahiemah PandieHatter Institute of Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Charles Kiiza MondoSt. Francis Hospital, Nsambya, Kampala, Uganda.
CREOLE Study Investigators
Makerere University · UGNsambya Hospital · UGUniversity of Abuja Teaching Hospital · NGBayero University Kano · NGBusitema University · UGEduardo Mondlane University · MZImperial College London · GBMoi University · KEUniversity of Cape Town · ZAUniversity of Douala · CMUniversity of Ibadan · NGUniversity of Nairobi · KE

Funding

Training in noncommunicable diseases epidemiological, data science and Implementation Science research to strengthen evidence-based interventions, policy and control in Uganda.D43TW011401 · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · 2025 to 2025
$269k
FIC NIH HHS D43 TW011401
6 · The paper itself

Abstract

backgroundDipping of blood pressure (BP) at night is a normal physiological phenomenon. However, a non-dipping pattern is associated with hypertension mediated organ damage, secondary forms of hypertension and poorer long-term outcome. Identifying a non-dipping pattern may be useful in assessing risk, aiding the decision to investigate for secondary causes, initiating treatment, assisting decisions on choice and timing of antihypertensive therapy, and intensifying salt restriction.

objectivesTo estimate the prevalence and factors associated with non-dipping pattern and determine the effect of 6 months of three antihypertensive regimens on the dipping pattern among Black African hypertensive patients.

methodsThis was a secondary analysis of the CREOLE Study which was a randomized, single blind, three-group trial conducted in 10 sites in 6 Sub-Saharan African countries. The participants were 721 Black African patients, aged between 30 and 79 years, with uncontrolled hypertension and a baseline 24-h ambulatory blood pressure monitoring (ABPM). Dipping was calculated from the average day and average night systolic blood pressure measures.

resultsThe prevalence of non-dipping pattern was 78% (564 of 721). Factors that were independently associated with non-dipping were: serum sodium > 140 mmol/l (OR = 1.72, 95% CI 1.17-2.51, p-value 0.005), a higher office systolic BP (OR = 1.03, 95% CI 1.01-1.05, p-value 0.003) and a lower office diastolic BP (OR = 0.97, 95% CI 0.95-0.99, p-value 0.03). Treatment allocation did not change dipping status at 6 months (McNemar's Chi

conclusionThere was a high prevalence of non-dipping among Black Africans with uncontrolled hypertension. ABPM should be considered more routinely in Black Africans with uncontrolled hypertension, if resources permit, to help personalise therapy. Further research is needed to understand the mechanisms and causes of non-dipping pattern and if targeting night-time BP improves clinical outcomes. Trial registration ClinicalTrials.gov (NCT02742467).

Indexed as

Black PeopleBlood PressureAdultAfrica South of the SaharaAntihypertensive AgentsBlood Pressure Monitoring, AmbulatoryDrug Therapy, CombinationFemaleHumansHypertensionMaleMiddle AgedPrevalenceTime FactorsTreatment OutcomeAntihypertensive AgentsBlack AfricanDipping patternNon-dipping patternUncontrolled hypertension

Identifiers

PMID34022790
PMCPMC8141234
OpenAlexW3165134230

What Socratic holds

Textmetadata
LicenceCC BY
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.