The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Baseline predictors of resistant hypertension in the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT): a risk score to identify those at high-risk
Abstract
BACKGROUND: Resistant hypertension is a well recognized clinical entity, which has been inadequately researched to date. METHODS: A multivariable Cox model was developed to identify baseline predictors of developing resistant hypertension among 3666 previously untreated Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) patients and construct a risk score to identify those at high risk. Secondary analyses included evaluations among all 19 257 randomized patients. RESULTS: One-third (1258) of previously untreated, and one-half (9333) of all randomized patients (incidence rates 75.2 and 129.7 per 1000 person-years, respectively) developed resistant hypertension during a median follow-up of 5.3 and 4.8 years, respectively. Increasing strata of baseline SBP (151-160, 161-170, 171-180, and >180 mmHg) were associated with increased risk of developing resistant hypertension [hazard ratio 1.24 (95% confidence interval, CI 0.81-1.88), 1.50 (1.03-2.20), 2.15 (1.47-3.16), and 4.43 (3.04-6.45), respectively]. Diabetes, left ventricular hypertrophy, male sex, and raised BMI, fasting glucose, and alcohol intake were other significant determinants of resistant hypertension. Randomization to amlodipine ± perindopril vs. atenolol ± thiazide [0.57 (0.50-0.60)], previous use of aspirin [0.78 (0.62-0.98)], and randomization to atorvastatin vs. placebo [0.87 (0.76-1.00)] significantly reduced the risk of resistant hypertension. Secondary analysis results were similar. The risk score developed allows accurate risk allocation (Harrell's C-statistic 0.71), with excellent calibration (Hosmer-Lemeshow χ statistics, P = 0.99). A 12-fold (8.4-17.4) increased risk among those in the highest vs. lowest risk deciles was apparent. CONCLUSION: Baseline SBP and choice of subsequent antihypertensive therapy were the two most important determinants of resistant hypertension in the ASCOT population. Individuals at high risk of developing resistant hypertension can be easily identified using an integer-based risk score.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
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?
In the citing paper
“The higher prevalence of aTRH among treated hypertensive adults in clinical trials (34%−39%) is likely explained by the selection of patients with demographic and comorbidity characteristics that place them at high risk for the fatal and nonfatal CVD outcomes of interest.21–26”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [22]
Citations
Cites
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
2007 Guidelines for the Management of Arterial Hypertension
Mancia, G., Backer, G. D., Dominiczak, A. F., Cífková, R., Fagard, R. H., Germanò, G., Grassi, G. M., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., et al. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3281fc975a · Cited by 5,870
Dahlöf, B., Sever, P. S., Poulter, N. R., Wedel, H., Beevers, D. G., Caulfield, M., Collins, R., Kjeldsen, S. E., Kristinsson, A., McInnes, G. T., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67185-1 · Cited by 2,909
Self-citationResistant 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) · Circulation · doi:10.1161/circulationaha.108.189141 · Cited by 2,240
Rothwell, P. M., Howard, S. C., Dolan, E., O'Brien, E., Dobson, J. E., Dahlöf, B., Sever, P. S., & Poulter, N. R. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60308-x · Cited by 1,784
Self-citationThe CAFE Investigators, CAFE Steering Committee and Writing Committee, Williams, B., Lacy, P. S., Thom, S. M., Cruickshank, K., Stanton, A., Collier, D., Hughes, A. D., Thurston, H., et al. (2006) · Circulation · doi:10.1161/circulationaha.105.595496 · Cited by 1,645
Pepine, C. J., Handberg, E. M., Cooper‐DeHoff, R. M., Marks, R. G., Kowey, P. R., Messerli, F. H., Mancia, G., Cangiano, J. L., García-Barreto, D., Keltai, M., et al. (2003) · JAMA · doi:10.1001/jama.290.21.2805 · Cited by 1,278
Applying Cox Regression to Competing Risks
Lunn, M., & McNeil, D. (1995) · Biometrics · doi:10.2307/2532940 · Cited by 1,017
Cited by
Sorted by citations
Mancia, G., Kreutz, R., Brunström, M., Burnier, M., Grassi, G., Januszewicz, A., Muiesan, M. L., Tsioufis, K., Agabiti-Rosei, E., Algharably, E. A. E., et al. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003480 · Cited by 3,473
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
The pathophysiology of hypertension in patients with obesity
DeMarco, V. G., Aroor, A. R., & Sowers, J. R. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.44 · Cited by 545
Beta-blockers for hypertension
Wiysonge, C. S., Bradley, H., Volmink, J. A., Mayosi, B. M., & Opie, L. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002003.pub5 · Cited by 488
Prehypertension—prevalence, health risks, and management strategies
Egan, B. M., & Stevens-Fabry, S. (2015) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2015.17 · Cited by 247
Metadata
- Authors
- Gupta, A. K., Nasothimiou, E. G., Chang, C. L., Sever, P. S., Dahlöf, B., & Poulter, N. R.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Gupta, Ajay K.
- Venue
- Journal of Hypertension
- Published
- 2011-10
- Volume
- 29
- Issue
- 10
- Pages
- 2004-2013
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2082072583
- Cited by
- 165
- References
- 26
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 8 · 2023: 11 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 10 · 2018: 10 · 2017: 15 · 2016: 13 · 2015: 14 · 2014: 26 · 2013: 21 · 2012: 13
- FWCI
- 13.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- National Institute for Health and Care Research (NF-SI-0508-10116)
- British Heart Foundation
- Servier
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- resistant hypertension, baseline predictors, risk score, systolic blood pressure, antihypertensive therapy, amlodipine, perindopril, atenolol, thiazide diuretics, atorvastatin, aspirin, diabetes mellitus, left ventricular hypertrophy, alcohol consumption, body mass index, hypertension incidence, ASCOT trial
- MeSH terms
- Aged, Algorithms, Antihypertensive Agents, Atenolol, Bendroflumethiazide, Diuretics, Drug Resistance, Female, United Kingdom, Humans, Hypertension, Ireland, Male, Middle Aged, Risk Factors, Scandinavian and Nordic Countries, Amlodipine, Perindopril
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
