Evidence mapPaperPMID 34501937Full record

ArticleInternational journal of environmental research and public health2021

Systolic Blood Pressure and Outcomes in Stable Outpatients with Recent Symptomatic Artery Disease: A Population-Based Longitudinal Study.

Juan F Sánchez Muñoz-Torrero, Guillermo Escudero-Sánchez, Julián F Calderón-García, Sergio Rico-Martín, Nicolás Roberto Robles, M Asunción Bacaicoa, José N Alcalá-Pedrajas, Guadalupe Gil-Fernández, Manuel Monreal, On Behalf Of The Frena Investigators

Open access · goldAbstract read
In one paragraph

Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
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

10 authors at 7 institutions in 1 country.

Juan F Sánchez Muñoz-TorreroDepartment of Internal Medicine, Hospital San Pedro Alcántara, 10003 Cáceres, Spain.
Guillermo Escudero-SánchezDepartment of Internal Medicine, Hospital Virgen Del Puerto, Plasencia, 10003 Cáceres, Spain.
Julián F Calderón-GarcíaDepartment of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain.
Sergio Rico-MartínDepartment of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain.ORCID 0000-0003-4932-1940
Nicolás Roberto RoblesDepartment of Nephrology, Hospital Infanta Cristina, 06080 Badajoz, Spain.
M Asunción BacaicoaCentro de Salud Manuel Encinas, 10001 Cáceres, Spain.
José N Alcalá-PedrajasDepartment of Internal Medicine, Hospital Comarcal Valle de los Pedroches, 14400 Pozoblanco, Spain.
Guadalupe Gil-FernándezDepartment of Nursing, Faculty of Medicine, University of Extremadura, 06080 Badajoz, Spain.ORCID 0000-0002-2050-5722
Manuel MonrealDepartment of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, 08916 Barcelona, Spain.ORCID 0000-0002-0494-0767
On Behalf Of The Frena Investigators
Universidad de Extremadura · ESComplejo Hospitalario de Cáceres · ESHospital Comarcal de Inca · ESHospital San Pedro de Alcántara · ESHospital Universitari Germans Trias i Pujol · ESHospital Universitario Infanta Cristina · ESHospital Virgen del Puerto · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe most appropriate targets for systolic blood pressure (SBP) levels to reduce cardiovascular morbidity and mortality in patients with symptomatic artery disease remain controversial. We compared the rate of subsequent ischemic events or death according to mean SBP levels during follow-up.

designProspective cohort study. FRENA is an ongoing registry of stable outpatients with symptomatic coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD).

setting24 Spanish hospitals.

participants4789 stable outpatients with vascular disease.

resultsAs of June 2017, 4789 patients had been enrolled in different Spanish centres. Of these, 1722 (36%) had CAD, 1383 (29%) CVD and 1684 (35%) PAD. Over a mean follow-up of 18 months, 136 patients suffered subsequent myocardial infarction, 125 had ischemic stroke, 74 underwent limb amputation, and 260 died. On multivariable analysis, CVD patients with mean SBP levels 130-140 mm Hg had a lower risk of mortality than those with levels <130 mm Hg (hazard ratio (HR): 0.39; 95% CI: 0.20-0.77), as did those with levels >140 mm Hg (HR: 0.46; 95% CI: 0.26-0.84). PAD patients with mean SBP levels >140 mm Hg had a lower risk for subsequent ischemic events (HR: 0.57; 95% CI: 0.39-0.83) and those with levels 130-140 mm Hg (HR: 0.47; 95% CI: 0.29-0.78) or >140 mm Hg (HR: 0.32; 95% CI: 0.21-0.50) had a lower risk of mortality. We found no differences in patients with CAD.

conclusionsIn this real-world cohort of symptomatic arterial disease patients, most of whom are not eligible for clinical trials, the risk of subsequent events and death varies according to the levels of SBP and the location of previous events. Especially among patients with large artery atherosclerosis, PAD or CVD, SBP <130 mm Hg may result in increased mortality. Due to potential factors in this issue, Prospective, well designed studies are warranted to confirm these observational data.

Indexed as

OutpatientsPeripheral Arterial DiseaseArteriesBlood PressureHumansLongitudinal StudiesProspective StudiesRisk Factorsdeathischemic eventoutcomessymptomatic artery diseasesystolic blood pressure

Identifiers

PMID34501937
PMCPMC8431050
OpenAlexW3197806269

What Socratic holds

Textmetadata
LicenceCC BY
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.