SynthesisJournal of the American Geriatrics Society2022
Time to benefit for stroke reduction after blood pressure treatment in older adults: A meta-analysis.
Synthesis in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Time to Benefit of Surgery vs Targeted Medical Therapy for Patients With Primary Aldosteronism: A Meta-analysis.The Journal of clinical endocrinology and metabolism · 2024Pooled it
- Clinical practice guidelines for diagnostic and treatment of the chronic heart failure.Archivos de cardiologia de Mexico · 2024Guideline
- Time to benefit for stroke reduction after blood pressure treatment in older adults: A meta-analysis.Journal of the American Geriatrics Society · 2022Pooled it
- Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Enrollment of Historically Underrepresented Groups in Peripheral Arterial Disease Trials: A Systematic Review.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Review
- Comparison of the therapeutic effects of traditional Chinese medicine exercise therapies on blood pressure, lipids, and sleep quality among older patients suffering from hypertension: a systematic review and network meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Metformin use on the risks of depression and anxiety in people with type 2 diabetes.Communications medicine · 2025Article
- The Impact of Aerobic Exercise on Health Management in Older Patients with Hypertension: A Systematic Review of Randomized Controlled Trials from the Past Decade.International journal of general medicine · 2025Review
- Tension at the gate: sensing mechanical forces at the blood-brain barrier in health and disease.Journal of neuroinflammation · 2024Review
- Optimal Blood Pressure Targets with Age.Clinics in geriatric medicine · 2024Review
- Unleashing frailty from laboratory into real world: A critical step toward frailty-guided clinical care of older adults.Journal of the American Geriatrics Society · 2024Article
- We have the technology: Why aren't better blood pressure data available from nursing home residents?Journal of the American Geriatrics Society · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHypertension treatment in older adults can decrease mortality, cardiovascular events, including heart failure, cognitive impairment, and stroke risk, but may also lead to harms such as syncope and falls. Guidelines recommend targeting preventive interventions with immediate harms and delayed benefits to patients whose life expectancy exceeds the intervention's time to benefit (TTB). Our objective was to estimate a meta-analyzed TTB for stroke prevention after initiation of more intensive hypertension treatment in adults aged ≥65 years.
methodsStudies were identified from two Cochrane systematic reviews and a search of MEDLINE and Google Scholar for subsequent publications until August 31, 2021. We abstracted data from randomized controlled trials comparing standard (untreated, placebo, or less intensive treatment) to more intensive treatment groups in older adults (mean age ≥ 65 years). We fit Weibull survival curves and used a random-effects model to estimate the pooled annual absolute risk reduction (ARR) between control and intervention groups. We applied Markov chain Monte Carlo methods to determine the time to ARR thresholds (0.002, 0.005, and 0.01) for a first stroke.
resultsNine trials (n = 38,779) were identified. The mean age ranged from 66 to 84 years and study follow-up times ranged from 2.0 to 5.8 years. We determined that 1.7 (95%CI: 1.0-2.9) years were required to prevent 1 stroke for 200 persons (ARR = 0.005) receiving more intensive hypertensive treatment. Heterogeneity was found across studies, with those focusing on tighter systolic blood pressure control (SBP < 150 mmHg) showing longer TTB. For example, in the SPRINT study (baseline SBP = 140 mmHg, achieved SBP = 121 mmHg), the TTB to avoid 1 stroke for 200 patients treated was 5.9 years (95%CI: 2.2-13.0).
conclusionsMore intensive hypertension treatment in 200 older adults prevents 1 stroke after 1.7 years. Given the heterogeneity across studies, the TTB estimates from individual studies may be more relevant for clinical decision-making than our summary estimate.
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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.