Evidence map›Paper›PMID 36787937›Full record

Trial reportDiabetes care2023

Effects of Intensive Systolic Blood Pressure Lowering on End-Stage Kidney Disease and Kidney Function Decline in Adults With Type 2 Diabetes Mellitus and Cardiovascular Risk Factors: A Post Hoc Analysis of ACCORD-BP and SPRINT.

Yahya M K Tawfik, Benjamin W Van Tassell, Dave L Dixon, William L Baker, John Fanikos, Leo F Buckley

Open access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 11% 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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Evaluating blood pressure targets in chronic kidney disease: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Time in target range of systolic blood pressure and eGFR slope in patients with type 2 diabetes.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Trial
  5. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  6. Review
  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

6 authors at 3 institutions in 2 countries.

Yahya M K TawfikDepartment of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.
Benjamin W Van TassellDepartment of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA.
Dave L DixonDepartment of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA.
William L BakerDepartment of Pharmacy Practice, University of Connecticut, Storrs, CT.
John FanikosDepartment of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.
Leo F BuckleyDepartment of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.ORCID 0000-0003-1570-1486
Brigham and Women's Hospital · USVirginia Commonwealth University · USUniversity of Connecticut · US

Funding

Inflammasome Activity as a Potential Contributor to Uremic CardiomyopathyK23HL150311 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BUCKLEY, LEO FRANCIS · 2020 to 2024
$1.1M
NHLBI NIH HHS K23 HL150311NHLBI NIH HHS K23HL150311
6 · The paper itself

Abstract

objectiveTo determine the effects of intensive systolic blood pressure (SBP) lowering on the risk of major adverse kidney outcomes in people with type 2 diabetes mellitus (T2DM) and/or prediabetes and cardiovascular risk factors. RESEARCH DESIGN AND

methodsThis post hoc ACCORD-BP subgroup analysis included participants in the standard glucose-lowering arm with cardiovascular risk factors required for SPRINT eligibility. Cox proportional hazards regression models compared the hazard for the composite of dialysis, kidney transplant, sustained estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2, serum creatinine >3.3 mg/dL, or a sustained eGFR decline ≥57% between the intensive (<120 mmHg) and standard (<140 mmHg) SBP-lowering arms.

resultsThe study cohort included 1,966 SPRINT-eligible ACCORD-BP participants (40% women) with a mean age of 63 years. The mean SBP achieved after randomization was 120 ± 14 and 134 ± 15 mmHg in the intensive and standard arms, respectively. The kidney composite outcome occurred at a rate of 9.5 and 7.2 events per 1,000 person-years in the intensive and standard BP arms (hazard ratio [HR] 1.35 [95% CI 0.85-2.14]; P = 0.20). Intensive SBP lowering did not affect the risk of moderately (HR 0.96 [95% CI 0.76-1.20]) or severely (HR 0.92 [95% CI 0.66-1.28]) increased albuminuria. Including SPRINT participants with prediabetes in the cohort did not change the overall results.

conclusionsThis post hoc subgroup analysis suggests that intensive SBP lowering does not increase the risk of major adverse kidney events in individuals with T2DM and cardiovascular risk factors.

Indexed as

Diabetes Mellitus, Type 2HypertensionKidney Failure, ChronicPrediabetic StateAdultAntihypertensive AgentsBlood PressureCohort StudiesFemaleHumansKidneyMaleMiddle AgedRisk FactorsTreatment OutcomeAntihypertensive Agents

Identifiers

PMID36787937
PMCPMC10090906
OpenAlexW4320716030

What Socratic holds

Textmetadata
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.