Evidence mapPaperPMID 34518266Full record

Trial reportBMJ open2021

Intensive versus standard blood pressure control in type 2 diabetes: a restricted mean survival time analysis of a randomised controlled trial.

Sandra Shi, Natalia Gouskova, Mehdi Najafzadeh, Lee-Jen Wei, Dae Hyun Kim

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00000620. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.7field-weighted citation impact, top 14% 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.

NCT00000620 phase3completed

Action to Control Cardiovascular Risk in Diabetes (ACCORD)

Ran1999Enrolled10,251Registered outcomes6Posted comparisons6ConditionsAtherosclerosis, Cardiovascular Diseases, Coronary Disease, Diabetes MellitusArmsAnti-hyperglycemic Agents, Anti-hypertensive Agents, Blinded fenofibrate or placebo plus simvastatin
Open the trial in the graph
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
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

5 authors at 3 institutions in 1 country.

Sandra ShiHinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.ORCID 0000-0001-6801-5602
Natalia GouskovaHinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.
Mehdi NajafzadehDivision of Pharmacoepidemiology and Phamacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Lee-Jen WeiHarvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Dae Hyun KimHinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA daehyunkim@hsl.harvard.edu.
Brigham and Women's Hospital · USHebrew SeniorLife · USHarvard University · US

Funding

NIA NIH HHS R21 AG060227
6 · The paper itself

Abstract

backgroundRestricted mean survival time analysis offers an intuitive and robust summary of treatment effect compared with HRs.

objectiveTo examine the effect of intensive versus standard blood pressure (BP) control on death or cardiovascular events in type 2 diabetes.

designSecondary analysis of the Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial.

setting77 sites in the USA and Canada.

participants4733 adults with type 2 diabetes at high risk for cardiovascular events.

interventionsSystolic BP target <120 mm Hg (n=2371) versus <140 mm Hg (n=2362). MEASUREMENTS: Composite endpoint of death, non-fatal myocardial infarction or non-fatal stroke.

resultsThe mean event-free survival time over 5 years (1825 days) was similar between intensive and standard BP control (1716 vs 1714 days; mean difference, 1.3 (95% CI -18.1 to 20.7) days). However, intensive BP treatment was more beneficial for those assigned to standard glycaemic control (1725 vs 1697 days; mean difference, 28.1 (95% CI 0.4 to 55.9) days), but not for those assigned to intensive glycaemic control (1706 vs 1731 days; mean difference, -25.2 (95% CI -52.3 to 1.9) days) (p=0.008 for interaction). In subgroup analysis, the mean event-free survival time difference between intensive and standard BP treatment was -76.0 (95% CI -131.8 to -20.3) days for those with cognitive impairment and 21.8 (95% CI -24.0 to 67.5) days for those with normal cognitive function (p=0.008 for interaction). The effect was not different by age, sex and baseline cardiovascular disease status.

conclusionsIntensive BP treatment may reduce death and cardiovascular events among patients with type 2 diabetes receiving standard glycaemic treatment and without cognitive impairment. TRIAL REGISTRATION NUMBER: NCT00000620; Post-results.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2HypertensionMyocardial InfarctionAdultAntihypertensive AgentsBlood PressureHumansSurvival RateTreatment OutcomeAntihypertensive Agentsdiabetes & endocrinologygeriatric medicinehypertension

Identifiers

PMID34518266
PMCPMC8438933
OpenAlexW3201140601

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.