A reduced heart rate variability is independently associated with a blunted nocturnal blood pressure fall in patients with resistant hypertension
Abstract
BACKGROUND: A blunted nocturnal blood pressure (BP) fall is a marker of worse cardiovascular outcomes, and autonomic imbalance may be involved. The objective was to evaluate the associations between the nocturnal BP fall and heart rate variability (HRV) parameters in resistant hypertension. DESIGN AND METHODS: In a cross-sectional analysis, 424 resistant hypertensive patients performed 24-h ambulatory BP and Holter monitoring, and 221 patients also performed polysomnography. Time-domain HRV parameters evaluated were the standard deviation of all normal RR intervals (SDNN), the standard deviation of the averaged normal RR intervals for all 5-min segments (SDANN), the root mean square of differences between adjacent R-R intervals (rMSSD) and the percentage of adjacent R-R intervals that varied by more than 50 ms (pNN50). Multivariate linear and logistic regressions assessed associations between the nocturnal BP fall and HRV parameters. RESULTS: Two hundred and sixty-six patients (63%) presented a nondipping pattern. These patients had lower SDNN and SDANN than normal dipping patients, but equal rMSSD and pNN50. On multivariate analysis, after adjustments for several confounders, a reduced SDNN (<70 ms) implied a 2.9 to 3.4-fold [95% confidence interval (CI) 1.2-8.5] and a reduced SDANN (<50 ms) a 3.7 to 4.2-fold (95% CI 1.5-11.4) higher odds of having a nondipping pattern. Further adjustment for the presence and severity of obstructive sleep apnoea did not change the results. CONCLUSION: Reduced SDNN and SDANN, two HRV parameters that mainly reflect sympathetic overactivity, were independently associated with a blunted nocturnal BP fall in resistant hypertension. These relationships offer insight into physiopathological mechanisms linking the circadian BP variability to cardiovascular outcomes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The normal nocturnal decline in blood pressure is attenuated in a high proportion (43%-65%) of individuals with resistant hypertension.
“The normal nocturnal decline in BP is also attenuated in a high proportion (43%−65%) of individuals with RH.32,53,54”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [53]
Nondipping ambulatory blood pressure in individuals with resistant hypertension has been linked to reduced heart rate variability, a marker of sympathetic nervous system overactivity.
“Nondipping ambulatory BP in individuals with RH has been linked to reduced heart rate variability, a marker of sympathetic nervous system overactivity.53”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [53]
Cites
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289 · see citing works
Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence
Morisky, D. E., Green, L. W., & Levine, D. M. (1986) · Medical Care · doi:10.1097/00005650-198601000-00007 · Cited by 5,304 · see citing works
Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method.
Devereux, R. B., & Reichek, N. (1977) · Circulation · doi:10.1161/01.cir.55.4.613 · Cited by 4,499 · see citing works
Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine, Epstein, L. J., Kristo, D., Strollo, P. J., Friedman, N., Malhotra, A., Patil, S. P., Ramar, K., Rogers, R., Schwab, R. J., et al. (2009) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27497 · Cited by 3,360 · see citing works
Rovere, M. T. L., Bigger, J. T., Marcus, F. I., Mortara, A., & Schwartz, P. J. (1998) · The Lancet · doi:10.1016/s0140-6736(97)11144-8 · Cited by 3,120 · see citing works
Using the Berlin Questionnaire To Identify Patients at Risk for the Sleep Apnea Syndrome
Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-131-7-199910050-00002 · Cited by 2,973 · see citing works
Bortel, L. M. V., Laurent, S., Boutouyrie, P., Chowienczyk, P., Cruickshank, J. K., Backer, T. L. M. D., Filipovský, J., Huybrechts, S. A. M., Mattace-Raso, F. U. S., Protogerou, A. D., et al. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e32834fa8b0 · Cited by 2,012 · see citing works
Resistant Hypertension: Diagnosis, Evaluation, and Treatment
Calhoun, D. A., Jones, D. W., Textor, S. C., Goff, D. C., Murphy, T. P., Toto, R. D., White, A. J., Cushman, W. C., White, W. B., Sica, D. A., et al. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.189141 · Cited by 1,404 · see citing works
Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study
Tsuji, H., Venditti, F. J., Manders, E. S., Evans, J. C., Larson, M. G., Feldman, C. L., & Levy, D. (1994) · Circulation · doi:10.1161/01.cir.90.2.878 · Cited by 1,114 · see citing works
Ohkubo, T., Hozawa, A., Yamaguchi, J., Kikuya, M., Ohmori, K., Michimata, M., Matsubara, M., Hashimoto, J., Hoshi, H., Araki, T., et al. (2002) · Journal of Hypertension · doi:10.1097/00004872-200211000-00017 · Cited by 1,053 · see citing works
La Rovere, M. T., Pinna, G. D., Maestri, R., Mortara, A., Capomolla, S., Febo, O., Ferrari, R., Franchini, M., Gnemmi, M., Opasich, C., et al. (2003) · Circulation · doi:10.1161/01.cir.0000047275.25795.17 · Cited by 917 · see citing works
Pedrosa, R. P., Drager, L. F., Gonzaga, C. C., Sousa, M. G., de Paula, L. K. G., Amaro, A. C. S., Amodeo, C., Bortolotto, L. A., Krieger, E. M., Bradley, T. D., et al. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.179788 · Cited by 668 · see citing works
Prognostic Value of Ambulatory Blood Pressure
Verdecchia, P. (2000) · Hypertension · doi:10.1161/01.hyp.35.3.844 · Cited by 616 · see citing works
Reduced Heart Rate Variability and New-Onset Hypertension
Singh, J. P., Larson, M. G., Tsuji, H., Evans, J. C., O’Donnell, C. J., & Levy, D. A. (1998) · Hypertension · doi:10.1161/01.hyp.32.2.293 · Cited by 561 · see citing works
Gerritsen, J., Dekker, J. M., TenVoorde, B. J., Kostense, P. J., Heine, R. J., Bouter, L. M., Heethaar, R. M., & Stehouwer, C. D. A. (2001) · Diabetes Care · doi:10.2337/diacare.24.10.1793 · Cited by 456 · cited 1× · see citing works
“Reduced HRV was also demonstrated to predict worse cardiovascular prognosis not only in patients with coronary heart disease [6,7] and heart failure [8,9] but also in diabetic and hypertensive individuals [10,11] and in elderly population [12].”
BackgroundHypertension, Blood Pressure, and Heart Rate Variability
Schroeder, E. B., Liao, D., Chambless, L. E., Prineas, R. J., Evans, G. W., & HEISS, G. M. (2003) · Hypertension · doi:10.1161/01.hyp.0000100444.71069.73 · Cited by 452 · see citing works
Xhyheri, B., Manfrini, O., Mazzolini, M., Pizzi, C., & Bugiardini, R. (2012) · Progress in cardiovascular diseases · doi:10.1016/j.pcad.2012.09.001 · Cited by 450 · see citing works
ACC/AHA guidelines for ambulatory electrocardiography
Crawford, M. H., Bernstein, S. J., Deedwania, P. C., DiMarco, J. P., Ferrick, K. J., Garson, A., Green, L. A., Greene, H. L., Silka, M. J., Stone, P. H., et al. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00354-x · Cited by 309 · see citing works
Liao, D., Carnethon, M. R., Evans, G. W., Cascio, W. E., & HEISS, G. M. (2002) · Diabetes · doi:10.2337/diabetes.51.12.3524 · Cited by 304 · see citing works
Nighttime blood pressure dipping: the role of the sympathetic nervous system
Sherwood, A., Steffen, P. R., Blumenthal, J. A., Kuhn, C. M., & Hinderliter, A. L. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(01)02251-8 · Cited by 289 · see citing works
Autonomic Nervous Function in Non-dipper Essential Hypertensive Subjects
Kohara, K., Nishida, W., Maguchi, M., & Hiwada, K. (1995) · Hypertension · doi:10.1161/01.hyp.26.5.808 · Cited by 258 · see citing works
Position paper on the management of patients with obstructive sleep apnea and hypertension
Parati, G., Lombardi, C., Hedner, J. A., Bonsignore, M. R., Grote, L., Tkáčová, R., Levy, P. A., Riha, R. L., Bassetti, C. L., Narkiewicz, K., et al. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e328350e53b · Cited by 219 · see citing works
Kearney, M. T., Fox, K. A. A., Lee, A. J., Prescott, R. J., Shah, A. M., Batin, P. D., Baig, W., Lindsay, S. F., Callahan, T. S., Shell, W. E., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02490-7 · Cited by 219 · see citing works
Adrenergic, Metabolic, and Reflex Abnormalities in Reverse and Extreme Dipper Hypertensives
Grassi, G. M., Seravalle, G., Quarti‐Trevano, F., Dell’Oro, R., Bombelli, M., Cuspidi, C., Facchetti, R., Bolla, G. B., & Mancia, G. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.116368 · Cited by 214 · see citing works
Prognostic Value of Nocturnal Blood Pressure Reduction in Resistant Hypertension
Muxfeldt, E. S., Cardoso, C. R. L., & Salles, G. F. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.68 · Cited by 155 · see citing works
Self-citationA validation of the Mobil O Graph (version 12) ambulatory blood pressure monitor
Jones, C., Taylor, K., Chowienczyk, P., Poston, L., & Shennan, A. H. (2000) · Blood Pressure Monitoring · doi:10.1097/00126097-200008000-00007 · Cited by 129 · see citing works
Interpreting oscillations of muscle sympathetic nerve activity and heart rate variability
Pagani, M., & Malliani, A. (2000) · Journal of Hypertension · doi:10.1097/00004872-200018120-00002 · Cited by 121 · see citing works
Clinical characteristics of patients with resistant hypertension: the RESIST-POL study
Florczak, E., Prejbisz, A., Szwench-Pietrasz, E., Śliwiński, P., Bieleń, P., Klisiewicz, A., Michałowska, I., Warchoł, E., Januszewicz, M., Kała, M., et al. (2013) · Journal of Human Hypertension · doi:10.1038/jhh.2013.32 · Cited by 120 · see citing works
Nakano, Y., Oshima, T., Ozono, R., Higashi, Y., Sasaki, S., Matsumoto, T., Matsuura, H., Chayama, K., & Kambe, M. (2001) · Autonomic Neuroscience · doi:10.1016/s1566-0702(01)00238-7 · Cited by 104 · see citing works
Kario, K., Motai, K., Mitsuhashi, T., Suzuki, T., Nakagawa, Y., Ikeda, U., Matsuo, T., Nakayama, T., & Shimada, K. (1997) · Hypertension · doi:10.1161/01.hyp.30.6.1504 · Cited by 101 · see citing works
Sayk, F., Becker, C., Teckentrup, C., Fehm, H., Struck, J., Wellhoener, J. P., & Dodt, C. (2007) · Hypertension · doi:10.1161/hypertensionaha.106.084343 · Cited by 92 · see citing works
Manfrini, O. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00345-2 · Cited by 73 · see citing works
Dauphinot, V., Gosse, P., Kossovsky, M. P., Schott, A., Rouch, I., Pichot, V., Gaspoz, J., Roche, F., & Barthélemy, J. (2010) · Hypertension Research · doi:10.1038/hr.2010.130 · Cited by 55 · see citing works
Castelpoggi, C. H., Pereira, V. S., Fiszman, R., Cardoso, C. R. L., Muxfeldt, E. S., & Salles, G. F. (2009) · Hypertension Research · doi:10.1038/hr.2009.71 · Cited by 55 · see citing works
Self-citationKario, K., Mitsuhashi, T., & Shimada, K. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)02266-5 · Cited by 50 · see citing works
Muxfeldt, E. S., & Salles, G. F. (2008) · Journal of Hypertension · doi:10.1097/hjh.0b013e3282f55021 · Cited by 50 · see citing works
Self-citationPalatini, P. (2004) · Journal of Hypertension · doi:10.1097/00004872-200412000-00007 · Cited by 30 · see citing works
Spectral analysis of heart rate variability in elderly non-dipper hypertensive patients
Rizzo, V., Campbell, S. V., Maio, F. D., Tallarico, D., Lorido, A., Petretto, F., Bianchi, A., & Carmenini, G. (1999) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1000810 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
Stress and Health: A Review of Psychobiological Processes
O'Connor, D. B., Thayer, J. F., & Vedhara, K. (2021) · Annual Review of Psychology · doi:10.1146/annurev-psych-062520-122331 · Cited by 948 · see citing works
The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes
Yugar, L. B. T., Yugar‐Toledo, J. C., Dinamarco, N., Sedenho‐Prado, L. G., Moreno, B. V. D., Rubio, T. D. A., Fattori, A., Rodrigues, B., Vilela-Martin, J. F., & Moreno, H. (2023) · Diagnostics · doi:10.3390/diagnostics13040785 · Cited by 137 · see citing works
Resistant Hypertension: Mechanisms and Treatment
Hwang, A. Y., Dietrich, E. A., Pepine, C. J., & Smith, S. M. (2017) · Current Hypertension Reports · doi:10.1007/s11906-017-0754-x · Cited by 47 · see citing works
What is resistant arterial hypertension?
Shalaeva, E. V., & Messerli, F. H. (2023) · Blood Pressure · doi:10.1080/08037051.2023.2185457 · Cited by 42 · see citing works
GuoQi, L., Zhang, C., Li, Y., Yang, J., Wu, J., Shao, Y., Ma, K., Zhang, X., Zhu, S., Du, J., et al. (2025) · Immunity · doi:10.1016/j.immuni.2025.06.003 · Cited by 36 · see citing works
Cılhoroz, B., Giles, D., Zaleski, A. L., Taylor, B. A., Fernhall, B., & Pescatello, L. S. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240220 · Cited by 28 · see citing works
Noninvasive Renal Denervation for Resistant Hypertension Using High-Intensity Focused Ultrasound
Rong, S., Zhu, H., Liu, D., Qian, J., Zhou, K., Zhu, Q., Jiang, Y., Yang, G., Deng, C., Zhang, D., et al. (2015) · Hypertension · doi:10.1161/hypertensionaha.115.05754 · Cited by 24 · see citing works
Posterior scleral deformation and autonomic dysfunction in normal tension glaucoma
Shin, D. Y., Jeon, S. J., Park, H.-Y. L., & Park, C. K. (2020) · Scientific Reports · doi:10.1038/s41598-020-65037-6 · Cited by 21 · see citing works
Hong, K. E., Kim, S. A., Shin, D.-Y., Park, C. K., & Park, H.-Y. L. (2022) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.63.5.26 · Cited by 20 · see citing works
Raimondo, D. D., Miceli, G., Casuccio, A., Tuttolomondo, A., Buttà, C., Zappulla, V., Schimmenti, C., Musiari, G., & Pinto, A. V. (2016) · Hypertension Research · doi:10.1038/hr.2016.6 · Cited by 20 · see citing works
Yu, Y., Xu, Y., Zhang, M., Wang, Y., Zou, W., & Gu, Y. (2018) · International Journal of Hypertension · doi:10.1155/2018/4067601 · Cited by 18 · see citing works
Wang, Q., Cui, Y., Purrunsing, Y., & Wang, N. (2018) · Chronobiology International · doi:10.1080/07420528.2018.1486850 · Cited by 17 · see citing works
Därr, R., Bursztyn, M., Pamporaki, C., Peitzsch, M., Siegert, G., Bornstein, S. R., & Eisenhofer, G. (2016) · Journal of Clinical Hypertension · doi:10.1111/jch.12791 · Cited by 15 · see citing works
Heart Rate Variability and Chronotype in Young Adult Men
Vondrasek, J. D., Alkahtani, S. A., Al-Hudaib, A. A., Habib, S. S., Al‐Masri, A. A., Grosicki, G. J., & Flatt, A. A. (2022) · Healthcare · doi:10.3390/healthcare10122465 · Cited by 13 · see citing works
Sherwood, A., Smith, P. J., Hinderliter, A. L., Georgiades, A., & Blumenthal, J. A. (2016) · American Heart Journal · doi:10.1016/j.ahj.2016.10.011 · Cited by 13 · see citing works
P wave indices, heart rate variability and anthropometry in a healthy South Asian population
O’Neill, J., Bounford, K., Anstey, A., D’Silva, J., Clark, L., Plein, S., & Tayebjee, M. H. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220662 · Cited by 12 · see citing works
Raimondo, D. D., Musiari, G., Casuccio, A., Colomba, D., Rizzo, G., Pirera, E., Pinto, A. V., & Tuttolomondo, A. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11121371 · Cited by 6 · see citing works
Chen, Y., Liu, N., Guo, Y., Zheng, C., Fu, D., Cai, Y., Nie, K., & Xia, L. (2023) · Medicine · doi:10.1097/md.0000000000036481 · Cited by 5 · see citing works
Dell’Oro, R., Quarti‐Trevano, F., Seravalle, G., Cuspidi, C., & Grassi, G. M. (2023) · Clinical Autonomic Research · doi:10.1007/s10286-023-00927-z · Cited by 4 · see citing works
Ushakov, A. V., Сергеевна, И. В., & Анатольевна, Г. А. (2017) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2017-4-23-28 · Cited by 4 · see citing works
The effect of COVID-19 infection on heart rate variability: A cross-sectional study
Huyut, M. A., Levent, F., Tütüncü, A., Özmen, G., Ormancı, D., & Vatansever, F. (2022) · International Journal of the Cardiovascular Academy · doi:10.4103/ijca.ijca_9_22 · Cited by 3 · see citing works
Blood Pressure Increases Before Pulse Rate During the Nocturnal Period in Hypertensive Patients
Kuramoto, M., Aizawa, M., Kuramoto, Y., Okabe, M., Sakata, Y., & Aizawa, Y. (2020) · International Heart Journal · doi:10.1536/ihj.19-695 · Cited by 2 · see citing works
Blalock, A. C. E., Brown, J. E., Vondrasek, J. D., Cross, B. L., Grosicki, G. J., & Flatt, A. A. (2025) · Chronobiology International · doi:10.1080/07420528.2025.2538578 · Cited by 1 · see citing works
Blood pressure variability in CKD patients with and without nocturnal hypertension
Karagiannidis, A. G., Theodorakopoulou, M. P., Iatridi, F., Schoina, M., Sampani, E., Mykoniatis, I., Stavropoulos, K., Kamperidis, V., Kanbay, M., & Sarafidis, P. A. (2025) · Journal of Human Hypertension · doi:10.1038/s41371-025-00998-7 · Cited by 1 · see citing works
Autonomic dysfunction in a group of lower extremities arterial disease outpatients
Buttà, C., Tuttolomondo, A., Casuccio, A., Raimondo, D. D., Miceli, G., Cuttitta, F., Zappulla, V., Corpora, F., & Pinto, A. V. (2021) · Minerva Cardiology and Angiology · doi:10.23736/s2724-5683.20.05094-x · Cited by 1 · see citing works
AlJaroudi, W. (2018) · Journal of Nuclear Cardiology · doi:10.1007/s12350-018-01514-w · Cited by 1 · see citing works
Manolis, A. J. (2020) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.734299250.793571584 · Cited by 1 · see citing works
Gumz, M. L., & Solocinski, K. (2015) · ChronoPhysiology and Therapy · doi:10.2147/cpt.s54342
Miceli, G., Velardo, M., Casuccio, A., Basso, M. G., & Tuttolomondo, A. (2023) · Research Square · doi:10.21203/rs.3.rs-3741079/v1
Xintong, L., Ning, L., Yanhong, G., Meili, P., Jiang, Y., & Yuliang, Z. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70515
Thuptimdang, W., Tawaranurak, K., Panyarath, P., Rakim, W., Wae-asae, K., & Khoo, M. C. K. (2026) · Sleep And Breathing · doi:10.1007/s11325-026-03592-4
- Authors
- Salles, G. F., Ribeiro, F. M., Guimarães, G. M., Muxfeldt, E. S., & Cardoso, C. R. L.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Corresponding author
- Salles, Gil F.
- Venue
- Journal of Hypertension
- Published
- 2014-03
- Volume
- 32
- Issue
- 3
- Pages
- 644-651
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2313251981
- Cited by
- 34
- References
- 38
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 2
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- resistant hypertension, heart rate variability, nocturnal blood pressure dipping, autonomic imbalance, sympathetic hyperactivity, circadian blood pressure variation, obstructive sleep apnea, cardiovascular risk
- MeSH terms
- Aged, Antihypertensive Agents, Blood Pressure, Circadian Rhythm, Cross-Sectional Studies, Drug Resistance, Female, Heart Rate, Humans, Hypertension, Male, Middle Aged, Prospective Studies, Electrocardiography, Ambulatory, Multivariate Analysis, Polysomnography, Blood Pressure Monitoring, Ambulatory, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
