{ "description": "Every record of the Cardiovascular Atlas in release 2b2017b84496b985, public channel.", "provenance": { "release_id": "2b2017b84496b985", "atlas": { "id": "cardio", "name": "Cardiovascular Atlas" }, "channel": "public", "schema_version": "0.5", "built_at": "2026-10-13T19:41:55Z", "content_digest": "2b2017b84496b98585d9e00c39e95d2f4df14beb0f652f723103aa95469f14ee", "runtime": { "node": "v26.0.0", "sqlite": "3.53.4" }, "engine": { "repository": "github.com/bengreen927/medical-atlas-core#engine", "commit_sha": "9b6ed54443317de51bece77ee7d6c9ee91b36402", "commit_date": "2026-10-13T19:41:28Z", "content_digest": "167936e4c6fd5d336782ceba059c194270939f2cce087bb7f5f1f49ce16aff36" }, "inputs": [ { "repository": "github.com/bengreen927/cardiovascular-atlas/atlas/cardio.json", "commit_sha": "49532bfa8b8808809bc244a23c769777e459a1e4", "commit_date": "2026-10-13T19:41:55Z", "content_digest": "7ee13bc1fdd5918cd51dc74e7a0e64a9846c554c8e442a027dfb47613e58ab8a" }, { "repository": "github.com/bengreen927/cardiovascular-atlas/corpus", "commit_sha": "49532bfa8b8808809bc244a23c769777e459a1e4", "commit_date": "2026-10-13T19:41:55Z", "content_digest": "aa70097bc727bf7400f06b54f9f5fd3113b94d70c411d6e2318ab7390dfacc92" }, { "repository": "github.com/bengreen927/cardiovascular-atlas/research#quotes", "commit_sha": "49532bfa8b8808809bc244a23c769777e459a1e4", "commit_date": "2026-10-13T19:41:55Z", "content_digest": "225a6f101f32fb3392956111ae37c8e25d8a65075135b4467b5cefd3861e8e21" }, { "repository": "github.com/bengreen927/medical-atlas-core/corpus/common", "commit_sha": "9b6ed54443317de51bece77ee7d6c9ee91b36402", "commit_date": "2026-10-13T19:41:28Z", "content_digest": "47e0ca41b1741f40dc239795b1a78ce900283aecdd94ef11cd75994b7dc0a29e" }, { "repository": "github.com/bengreen927/medical-atlas-core/research#quotes", "commit_sha": "9b6ed54443317de51bece77ee7d6c9ee91b36402", "commit_date": "2026-10-13T19:41:28Z", "content_digest": "736c2295d8a845d354e4f7ed0d0b81da570dfa6ec9bc8c1efedfb5f210f8d93d" } ], "release_metadata": "api/v1/meta.json", "about_page": "about/", "citations": { "note": "Each claim lists its citations, each naming a source snapshot: the retrieval date and content hash of what was read. Each source gives its reuse_basis.", "json": [ "downloads/2b2017b84496b985/atlas.json#/records/claims", "downloads/2b2017b84496b985/atlas.json#/records/sources" ], "csv": [ "downloads/2b2017b84496b985/csv/citation.csv", "downloads/2b2017b84496b985/csv/source.csv", "downloads/2b2017b84496b985/csv/source_snapshot.csv" ], "sqlite_tables": [ "citation", "source", "source_snapshot" ] }, "paths": "Paths are relative to the release root, the directory that holds index.html and api/." }, "reuse_terms": { "status": "chosen", "id": "CC-BY-NC-4.0", "name": "Creative Commons Attribution-NonCommercial 4.0 International", "short_name": "CC BY-NC 4.0", "url": "https://creativecommons.org/licenses/by-nc/4.0/", "summary": "credit the atlas, and do not use it commercially", "statement": "The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page.", "label": "Reuse terms: CC BY-NC 4.0", "about_path": "about/#reuse", "third_party_quotations": "Text quoted from a source stays under that source's own terms, given as the source's reuse_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third_party_quotations." }, "null_means": "Every field the schema defines is present. null means the record does not state it; it never means zero or none.", "schema": "downloads/2b2017b84496b985/schema.json", "records": { "atlas": { "id": "cardio", "name": "Cardiovascular Atlas", "scope": "Risk and prevention; hypertension; coronary and vascular disease; stroke; arrhythmias; heart failure; valvular and congenital disease; diabetes/metabolic disease; kidney connections; acute care, procedures, rehabilitation and long-term living", "headline": "Heart and vessel evidence, with who each claim applies to.", "lede": "This atlas connects conditions, treatments, studies and the organizations behind them. Pages start in plain words, and every result keeps its population, follow-up and source.", "theme": "stone-cobalt", "sections": [ { "id": "explore", "label": "Explore", "description": "Search, conditions, care topics, technologies, interventions, products, comparison, graph explorer" }, { "id": "understand-care", "label": "Understand care", "description": "Prevention, symptoms/diagnosis, normal physiology, care pathways, biological pathways, glossary" }, { "id": "evidence-and-progress", "label": "Evidence & progress", "description": "Studies, publications, guidelines, results, historical timeline, evidence gaps and recent changes" }, { "id": "people-and-organizations", "label": "People & organizations", "description": "Researchers, clinicians, companies, institutions, journals, funders and datasets" }, { "id": "living-and-support", "label": "Living & support", "description": "Life-stage or condition reading guides, everyday impacts, recovery, rehabilitation, access and questions to ask" }, { "id": "open-questions", "label": "Open questions", "description": "Bottlenecks, existing efforts, hypotheses, proposed experiments and technology roadmaps" }, { "id": "about-and-contribute", "label": "About & contribute", "description": "Methodology, coverage, disclaimer, corrections, contributors, source licenses, API and downloads" } ], "navigation": [ { "id": "system", "label": "Organ or system", "description": "Browse by the part of the body a page is mainly about.", "terms": [ { "id": "heart", "label": "Heart", "description": "The heart muscle, its valves and its rhythm." }, { "id": "blood-vessels", "label": "Blood vessels", "description": "Arteries and veins, including blood pressure." }, { "id": "brain", "label": "Brain", "description": "The blood supply to the brain, including stroke." }, { "id": "kidneys", "label": "Kidneys", "description": "Kidney conditions that are linked with heart and vessel health." }, { "id": "metabolism", "label": "Metabolism", "description": "Diabetes, blood fats and other metabolic conditions." } ] }, { "id": "condition-area", "label": "Condition area", "description": "Browse by the group of conditions a page belongs to.", "terms": [ { "id": "risk-and-prevention", "label": "Risk and prevention", "description": "What raises the chance of heart and vessel disease, and what lowers it." }, { "id": "hypertension", "label": "High blood pressure", "description": "Raised blood pressure and its treatment." }, { "id": "coronary-and-vascular-disease", "label": "Coronary and vascular disease", "description": "Narrowed or blocked arteries of the heart and body." }, { "id": "stroke", "label": "Stroke", "description": "Stroke and related conditions of the blood supply to the brain." }, { "id": "arrhythmias", "label": "Heart rhythm problems", "description": "A heartbeat that is too fast, too slow or irregular." }, { "id": "heart-failure", "label": "Heart failure", "description": "A heart that does not pump as well as it should." }, { "id": "valvular-and-congenital-disease", "label": "Valve and congenital heart disease", "description": "Heart valve conditions and heart conditions present from birth." }, { "id": "diabetes-and-metabolic-disease", "label": "Diabetes and metabolic disease", "description": "Diabetes and other metabolic conditions that affect the heart and vessels." }, { "id": "kidney-connections", "label": "Kidney connections", "description": "Where kidney health and heart and vessel health meet." }, { "id": "acute-care-and-long-term-living", "label": "Acute care and long-term living", "description": "Emergency care, procedures, rehabilitation and living with a condition." } ] } ], "publication": "unreviewed", "base_url": "https://cardio.openmedicalatlas.org/" }, "entities": [ { "id": "core:blood-pressure", "owner": "core", "slug": "blood-pressure", "name": "Blood pressure", "aliases": [ "BP" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "How hard the blood pushes on the arteries and other blood vessels. Oscillometric blood pressure devices estimate a systolic value and a diastolic value.", "summary_technical": "MeSH descriptor D001794, Blood Pressure. Systolic and diastolic pressure are the two values that oscillometric devices estimate. Diagnostic thresholds and targets are not part of this identity. Each belongs in a cited claim about a named guideline edition.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "mesh", "value": "D001794" } ], "relationships": [ { "predicate": "related_to", "object": "core:hypertension", "claim": null, "label": "Diagnosis thresholds are cited claims about blood pressure" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "biomarker", "payload": { "measure": "How hard the blood pushes on the arteries and other blood vessels. Oscillometric devices estimate it as a systolic value and a diastolic value.", "assay_context": null, "interpretation_claims": [] } }, { "id": "core:hypertension", "owner": "core", "slug": "hypertension", "name": "Hypertension (high blood pressure)", "aliases": [ "High blood pressure" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "Blood pressure that stays higher than it should over time.", "summary_technical": "Persistently raised arterial pressure. Diagnostic and treatment thresholds differ by guideline and measurement method, so each threshold or target must be cited to a specific guideline edition.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "increases_risk_of", "object": "core:stroke", "claim": "cardio:claim-hypertension-raises-stroke-risk", "label": "WHO 2012: hypertension is a major risk factor for cardiovascular disease, in particular for heart attack and stroke" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "condition", "payload": { "taxonomy_codes": [], "recognition": null, "assessment": null, "burden_claims": [] } }, { "id": "core:stroke", "owner": "core", "slug": "stroke", "name": "Stroke", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "A sudden loss of brain function. It happens when part of the brain does not get enough blood or when there is bleeding inside the skull.", "summary_technical": "MeSH descriptor D020521 groups conditions in which brain function is lost suddenly, without convulsions, because the blood supply to the brain fails (ischemia) or because of bleeding inside the skull (intracranial hemorrhage). MeSH sorts strokes by where in the brain they occur, which vessels are involved, the cause, the age of the person and whether there is bleeding. Subtypes are not recorded here.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "mesh", "value": "D020521" } ], "relationships": [], "navigation": { "cardio": { "system": [ "brain" ], "condition-area": [ "stroke" ] } }, "kind": "condition", "payload": { "taxonomy_codes": [], "recognition": null, "assessment": null, "burden_claims": [] } }, { "id": "core:home-bp-monitoring", "owner": "core", "slug": "home-bp-monitoring", "name": "Home blood pressure monitoring", "aliases": [ "Self-measured blood pressure monitoring", "SMBP", "HBPM" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "Measuring your own blood pressure with a device, at home or somewhere else outside the clinic.", "summary_technical": "Also called self-measured blood pressure (SMBP) monitoring. The CDC describes the patient measuring blood pressure regularly outside the clinic, at home or elsewhere, with a home device and at different times. The JACC panel says self-monitored blood pressure is frequently measured in the home and also in public places, so the home is one setting of it. MeSH has a concept named Blood Pressure Monitoring, Home (M0456886), filed under the descriptor Blood Pressure Monitoring, Ambulatory (D018660). That concept's label and scope note name only the home, so it is not an exact match and no MeSH id is recorded. Recommendations, accuracy and effects belong in cited claims.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-nice-ng136-1-2-4", "label": "NICE NG136 1.2.4: if ABPM is unsuitable or not tolerated" }, { "predicate": "measures", "object": "core:blood-pressure", "claim": null, "label": "Measures blood pressure at home" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "test", "mechanism": "The person measures their own blood pressure with a home blood pressure device, at different points in time, outside the clinic.", "taxonomy_codes": [] } }, { "id": "core:lancet", "owner": "core", "slug": "lancet", "name": "The Lancet", "aliases": [ "Lancet" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "A medical journal published by Elsevier.", "summary_technical": "Crossref, the NLM Catalog and the ISSN Portal agree on the print ISSN 0140-6736 and the electronic ISSN 1474-547X, with ISSN-L 0140-6736. The NLM Catalog unique id is 2985213R.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "issn-print", "value": "0140-6736" }, { "namespace": "issn-electronic", "value": "1474-547X" }, { "namespace": "nlm-unique-id", "value": "2985213R" } ], "relationships": [], "navigation": null, "kind": "journal", "payload": { "publisher": "Elsevier", "scope": null } }, { "id": "core:nejm", "owner": "core", "slug": "nejm", "name": "The New England Journal of Medicine", "aliases": [ "N Engl J Med", "NEJM" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "A general medical journal that published the main reports of the SPRINT and iKMC trials.", "summary_technical": "Published by the Massachusetts Medical Society, per Crossref.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "journal", "payload": { "publisher": "Massachusetts Medical Society", "scope": null } }, { "id": "core:acc", "owner": "core", "slug": "acc", "name": "American College of Cardiology", "aliases": [ "ACC" ], "atlases": [ "cardio" ], "summary_plain": "A membership organization in the United States for the people who work in cardiovascular care and research.", "summary_technical": "ROR 03pgm1r86 gives the types education and funder. The organization's own website calls it the professional home for clinicians and researchers and speaks of members across the cardiovascular team.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "ror", "value": "03pgm1r86" } ], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "society" ] } }, { "id": "core:aha", "owner": "core", "slug": "aha", "name": "American Heart Association", "aliases": [ "AHA" ], "atlases": [ "cardio" ], "summary_plain": "A nonprofit organization in the United States that the Research Organization Registry also lists as a funder.", "summary_technical": "ROR 013kjyp64 gives the types funder and nonprofit and places the association in the United States.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "ror", "value": "013kjyp64" } ], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "core:fda", "owner": "core", "slug": "fda", "name": "U.S. Food and Drug Administration", "aliases": [ "FDA", "United States Food and Drug Administration" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "The US federal agency that regulates drugs, biological products and medical devices, and that is also responsible for the safety of food and cosmetics.", "summary_technical": "A US federal agency with regulatory duties, housed in the Department of Health and Human Services. This identity states nothing about any decision. Device clearances and other decisions belong to the records that cite them.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "ror", "value": "034xvzb47" } ], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "regulator" ] } }, { "id": "core:george-institute", "owner": "core", "slug": "george-institute", "name": "The George Institute for Global Health", "aliases": [ "The George Institute" ], "atlases": [ "cardio" ], "summary_plain": "A global health research organisation and registered charity. It says it has major centres in Australia, the UK, China and India.", "summary_technical": "ROR 023331s46 is the Australian record and gives the type facility. The organisation's own website describes it as a research organisation.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "ror", "value": "023331s46" } ], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "institution" ] } }, { "id": "core:outcome-death-any-cause", "owner": "core", "slug": "outcome-death-any-cause", "name": "Death from any cause", "aliases": [ "All-cause mortality" ], "atlases": [ "cardio", "maternal" ], "summary_plain": "Dying for any reason during a study's follow-up.", "summary_technical": "All-cause mortality. The time window belongs to each finding, not to this outcome.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "Death from any cause", "unit": null, "components": [] } }, { "id": "core:outcome-stroke", "owner": "core", "slug": "outcome-stroke", "name": "Stroke as an outcome", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "Having a stroke during a study's follow-up. Each study decides what counts as a stroke.", "summary_technical": "Stroke as a study endpoint. The meaning of stroke is the one described for core:stroke. Whether it counts fatal strokes, non-fatal strokes or only certain types, and the time window, belong to each finding and not to this outcome.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "related_to", "object": "core:stroke", "claim": null, "label": "Endpoint for the condition" } ], "navigation": { "cardio": { "system": [ "brain" ], "condition-area": [ "stroke" ] } }, "kind": "outcome", "payload": { "definition": "A stroke during a study's follow-up. What counts as a stroke is set by each study's own definition.", "unit": null, "components": [] } }, { "id": "core:automated-upper-arm-cuff-device", "owner": "core", "slug": "automated-upper-arm-cuff-device", "name": "Automated upper-arm cuff blood pressure device", "aliases": [], "atlases": [ "cardio", "maternal" ], "summary_plain": "A blood pressure device with a cuff for the upper arm that works out the reading itself from signals in the cuff.", "summary_technical": "The oscillometric method on the upper arm, as the JACC Scientific Expert Panel describes it. Automated follows the panel's meaning, in which a device can take several readings at set intervals from one start. The panel sets these apart from semi-automated devices, which need a manual start for every reading. FDA classifies noninvasive blood pressure measurement systems under product code DXN and 21 CFR 870.1130 as class II. That is a broader device type than this technology, so DXN is a broad mapping. This identity says nothing about the accuracy or validation of any device or the authorization of any product.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "measures", "object": "core:blood-pressure", "claim": null, "label": "Measures blood pressure" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "technology", "payload": { "principle": "The device reads pulse waves in a cuff on the upper arm, usually while the cuff deflates, and a device-specific algorithm turns them into systolic and diastolic readings (the oscillometric method). An automated device can take several readings at set intervals from one start.", "taxonomy_codes": [ { "system": "FDA product code", "version": "classification page last updated 2026-10-05, shown on the page as 10/05/2026", "code": "DXN", "label": "system, measurement, blood-pressure, non-invasive" } ], "strengths": [ "An automated device can take several readings at set intervals with a single start." ], "limitations": [ "Each manufacturer uses its own undisclosed algorithm to estimate the readings.", "Even validated devices must be used in a standardized way, which includes a cuff of the right size that fits correctly and sits at heart level on a bare upper arm." ], "required_infrastructure": [] } }, { "id": "cardio:cardiovascular-prevention", "owner": "cardio", "slug": "cardiovascular-prevention", "name": "Preventing heart attack, stroke and heart failure", "aliases": [ "Cardiovascular prevention" ], "atlases": [ "cardio" ], "summary_plain": "This page is the starting point for the atlas's prevention material. For now it is built around blood pressure, because the first evidence recorded here is about medicines that lower blood pressure. Other parts of prevention are not covered yet.", "summary_technical": "Scope page, not a clinical statement. The first evidence tied to it is an individual-participant meta-analysis of 48 randomised trials (BPLTTC, Lancet 2021). That paper defines a major cardiovascular event as a composite of fatal or non-fatal stroke, fatal or non-fatal myocardial infarction or ischaemic heart disease, or heart failure causing death or requiring admission to hospital. Blood pressure lowering medicine links to this topic through a claim that records the hazard ratios per 5 mm Hg systolic reduction.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "related_to", "object": "core:stroke", "claim": null, "label": "Stroke: one of the events this topic aims to prevent" }, { "predicate": "related_to", "object": "core:hypertension", "claim": null, "label": "High blood pressure: the area this topic starts with" } ], "navigation": { "cardio": { "condition-area": [ "risk-and-prevention" ] } }, "kind": "care_topic", "payload": { "scope": "Blood-pressure-related prevention first; other prevention areas are not covered yet. The sources read do not state an age group for this topic.", "life_stages": [], "care_setting": null } }, { "id": "cardio:idea-cuffless-bp-monitoring", "owner": "cardio", "slug": "idea-cuffless-bp-monitoring", "name": "Cuffless blood pressure monitoring", "aliases": [ "Cuffless wearable blood pressure devices" ], "atlases": [ "cardio" ], "summary_plain": "Many devices that measure blood pressure without an inflating cuff are on sale, and they claim to be accurate. A European hypertension expert group says they could change how high blood pressure is diagnosed and managed, but that questions about their accuracy must be answered first. Its 2022 statement says recent European Society of Hypertension guidelines do not recommend them for diagnosis or management, and its 2023 statement sets out six tests for checking them. The British and Irish Hypertension Society says that, until it has a way to validate wearables, none can receive its endorsement or approval. This page records that position. It does not say that any such device is accurate.", "summary_technical": "Hypothesis page with maturity set to early feasibility. The two European Society of Hypertension Working Group statements (2022 and 2023) were read as abstracts only, and neither names a patient population. The 2022 abstract calls cuffless monitors \"a wide and heterogeneous group of novel technologies and devices with different intended uses\". Some need individual cuff calibration, which the 2023 tests address through a recalibration test. The British and Irish Hypertension Society page says it has no formal validation process for wearables and that, until it has one, no wearable blood pressure device can receive its endorsement or approval. Newer studies of cuffless devices since 2023 were not read.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "related_to", "object": "core:automated-upper-arm-cuff-device", "claim": null, "label": "Some cuffless devices are calibrated against a cuff reading" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "idea", "payload": { "hypothesis": "Cuffless blood pressure devices could support the diagnosis and management of high blood pressure once a validation standard shows that they are accurate.", "rationale": "The European Society of Hypertension Working Group says these devices have \"considerable potential to improve the awareness, treatment, and management of hypertension\" and \"considerable potential for changing the diagnosis and management of hypertension\".", "test": "The 2023 European Society of Hypertension recommendations define six validation tests for intermittent cuffless devices: static, device position, treatment, awake and asleep, exercise and recalibration. Not every test is required for every device. A device would first need to pass the tests that apply to it.", "maturity": "early_feasibility", "proponents": [], "objections": [ "The 2022 statement says the established validation protocols for cuff devices are inadequate for cuffless devices.", "The 2022 statement says fundamental questions about accuracy, performance and implementation must be addressed before these devices can be recommended for clinical use.", "The 2023 statement says there were no generally accepted validation protocols for them at that time.", "The British and Irish Hypertension Society says that, until it has a way to validate wearables, none can receive its endorsement or approval." ] } }, { "id": "cardio:ambulatory-bp-monitoring", "owner": "cardio", "slug": "ambulatory-bp-monitoring", "name": "Ambulatory blood pressure monitoring (ABPM)", "aliases": [ "ABPM" ], "atlases": [ "cardio" ], "summary_plain": "Taking repeated blood pressure readings while a person goes about a normal waking day, to check whether a high reading in the clinic is confirmed.", "summary_technical": "NICE NG136 recommendation 1.2.3 offers ABPM to confirm a diagnosis of hypertension when clinic blood pressure is between 140/90 and 180/120 mmHg. Recommendation 1.2.6 asks for at least 2 readings an hour across the waking day and uses the average of at least 14 readings. MeSH D018660 is Blood Pressure Monitoring, Ambulatory. The devices used, their accuracy and their validation are outside this record, and so is any use in pregnancy. Recommendations are in the linked claims.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-nice-ng136-1-2-3", "label": "NICE NG136 1.2.3: to confirm the diagnosis" }, { "predicate": "measures", "object": "core:blood-pressure", "claim": null, "label": "Measures blood pressure through the waking day" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "test", "mechanism": "Readings are taken repeatedly across the person's normal waking day, and the average of the readings is used (NICE recommendation 1.2.6).", "taxonomy_codes": [ { "system": "MeSH", "version": "MeSH linked-data descriptor record fetched on 2026-10-11, lastUpdated 2015-06-22; the record states no yearly MeSH release", "code": "D018660", "label": "Blood Pressure Monitoring, Ambulatory" } ] } }, { "id": "cardio:bp-lowering-medicine", "owner": "cardio", "slug": "bp-lowering-medicine", "name": "Blood pressure lowering medicine", "aliases": [ "Antihypertensive medicine", "Antihypertensive drug treatment" ], "atlases": [ "cardio" ], "summary_plain": "Medicines that lower blood pressure, started and adjusted for adults whose high blood pressure is confirmed.", "summary_technical": "Pharmacological antihypertensive treatment as framed by the WHO 2021 guideline: when to start (recommendation 1, three statements with different populations and strength labels), the first-line drug classes (recommendation 4) and combination therapy as initial treatment (recommendation 5). The classes are thiazide and thiazide-like agents, ACE inhibitors or angiotensin-receptor blockers, and long-acting dihydropyridine calcium channel blockers. Targets sit on the linked target record. Treatment steps in NICE NG136 were not read by this cluster. Each recommendation claim states its own population and strength label. One effect claim comes from a pooled analysis of 48 trials of blood-pressure-lowering medicines (BPLTTC, Lancet 2021), whose participants are not described as adults.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r1a", "label": "WHO 2021 1a: start at systolic 140 mmHg or higher, or diastolic 90 mmHg or higher (strong)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r1b", "label": "WHO 2021 1b: with cardiovascular disease, systolic 130 to 139 mmHg (strong)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r1c", "label": "WHO 2021 1c: high risk, diabetes or kidney disease, systolic 130 to 139 mmHg (conditional)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r4", "label": "WHO 2021 4: first-line drug classes (strong)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r5", "label": "WHO 2021 5: combination therapy as initial treatment (conditional)" }, { "predicate": "evaluated_for", "object": "cardio:cardiovascular-prevention", "claim": "cardio:claim-bplttc-mace-per-5mmhg", "label": "BPLTTC 2021 pooled trials: major cardiovascular events per 5 mm Hg lower systolic pressure from treatment" }, { "predicate": "related_to", "object": "cardio:bp-lowering-to-target", "claim": null, "label": "Treatment and its target" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "medicine", "mechanism": null, "taxonomy_codes": [] } }, { "id": "cardio:bp-lowering-to-target", "owner": "cardio", "slug": "bp-lowering-to-target", "name": "Blood-pressure lowering to a target", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "Using medicines and lifestyle changes to bring blood pressure below a chosen number and keep it there.", "summary_technical": "Generic treat-to-target antihypertensive management. The target belongs to the guideline context or study arm, not to this entity.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-nice-ng136-target-under-80", "label": "NICE NG136 1.4.20: below 140/90 mmHg for adults under 80" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r6a", "label": "WHO 2021 6a: below 140/90 mmHg without comorbidities (strong)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r6b", "label": "WHO 2021 6b: systolic below 130 mmHg with cardiovascular disease (strong)" }, { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r6c", "label": "WHO 2021 6c: systolic below 130 mmHg at high risk (conditional)" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "medicine", "mechanism": null, "taxonomy_codes": [] } }, { "id": "cardio:intensive-sbp-lowering", "owner": "cardio", "slug": "intensive-sbp-lowering", "name": "Intensive systolic blood-pressure lowering (target below 120 mm Hg)", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "A treatment plan that adjusts blood-pressure medicines until the top number is under 120, rather than the more usual under 140.", "summary_technical": "Treat-to-target antihypertensive strategy with a systolic goal below 120 mm Hg, as tested in SPRINT. It is a strategy, not a specific drug.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "subtype_of", "object": "cardio:bp-lowering-to-target", "claim": null, "label": "A specific, lower target" }, { "predicate": "evaluated_for", "object": "core:hypertension", "claim": "cardio:claim-sprint-primary-effect", "label": "Evaluated in SPRINT, in adults 50 and over without diabetes or prior stroke" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "medicine", "mechanism": null, "taxonomy_codes": [] } }, { "id": "cardio:nonphysician-hypertension-treatment", "owner": "cardio", "slug": "nonphysician-hypertension-treatment", "name": "Hypertension treatment by nonphysician professionals, such as pharmacists and nurses", "aliases": [ "Nonphysician hypertension treatment" ], "atlases": [ "cardio" ], "summary_plain": "Health professionals who are not doctors, such as pharmacists and nurses, providing blood pressure medicine, as long as they have proper training and prescribing authority, follow set management protocols and work under a doctor's oversight.", "summary_technical": "WHO 2021 recommendation 8 (conditional, low-certainty evidence) suggests that nonphysician professionals such as pharmacists and nurses can provide pharmacological treatment of hypertension when proper training, prescribing authority, specific management protocols and physician oversight are in place. Which professionals may prescribe in a given country was not checked.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "recommended_for", "object": "core:hypertension", "claim": "cardio:claim-who-2021-r8", "label": "WHO 2021 8: with training, prescribing authority, protocols and physician oversight (conditional)" }, { "predicate": "requires", "object": "cardio:bp-lowering-medicine", "claim": null, "label": "The service delivers the medicines" } ], "navigation": { "cardio": { "condition-area": [ "hypertension" ] } }, "kind": "intervention", "payload": { "subtype": "service", "mechanism": null, "taxonomy_codes": [] } }, { "id": "cardio:salt-substitution", "owner": "cardio", "slug": "salt-substitution", "name": "Salt substitution (lower-sodium, potassium-containing salt)", "aliases": [ "Lower-sodium salt substitutes", "LSSS" ], "atlases": [ "cardio" ], "summary_plain": "Swapping ordinary table salt for a salt that has part of its sodium replaced with potassium. The aim is lower blood pressure and, over years, fewer strokes. In SSaSS, a trial in rural China among people with a past stroke or aged 60 or over with high blood pressure, villages that used a substitute had fewer strokes and deaths than villages that kept regular salt. WHO suggests adults in general populations use these products if they use table salt, but not people with kidney problems, children or pregnant women. The NICE hypertension guideline says potassium-containing substitutes should not be used by some groups, including older people and people with diabetes. These positions are shown side by side and are not merged.", "summary_technical": "Replaces part of the sodium chloride in table salt with potassium chloride. SSaSS used 75% sodium chloride and 25% potassium chloride by mass. WHO reviewed 26 randomized trials; in the 23 whose substitutes replaced sodium with potassium, sodium chloride ranged from 41 to 75% and potassium chloride from 19 to 50%. WHO notes that the blood-pressure-lowering effect is partly due to the potassium content, and that too much blood potassium (hyperkalaemia) may be harmful, especially with impaired kidney function. Claims: SSaSS stroke, death and hyperkalemia results in one rural Chinese population; WHO 2025 conditional recommendation (direction for); NICE NG136 1.4.5 caution (direction against) in a subgroup context.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "evaluated_for", "object": "core:stroke", "claim": "cardio:claim-ssass-stroke-effect", "label": "SSaSS, rural China (past stroke, or 60 or over with high blood pressure): fewer strokes with the substitute" }, { "predicate": "recommended_for", "object": "cardio:high-sodium-intake", "claim": "cardio:claim-who-2025-lsss", "label": "WHO 2025: conditional, for adults in general populations who use table salt, as part of cutting sodium (not a test for individual high intake)" }, { "predicate": "not_recommended_for", "object": "core:hypertension", "claim": "cardio:claim-nice-ng136-1-4-5-salt-caution", "label": "NICE 1.4.5: not for the groups it lists (always read with that subgroup context)" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "risk-and-prevention", "hypertension", "stroke" ] } }, "kind": "intervention", "payload": { "subtype": "lifestyle", "mechanism": "Lowers sodium intake and raises potassium intake.", "taxonomy_codes": [] } }, { "id": "cardio:mrc", "owner": "cardio", "slug": "mrc", "name": "Medical Research Council (United Kingdom)", "aliases": [ "MRC" ], "atlases": [ "cardio" ], "summary_plain": "A UK research funder that PubMed lists for the SSaSS paper.", "summary_technical": "PubMed lists Medical Research Council grant MR/S019669/1, country United Kingdom, for the SSaSS paper. The abstract names only the Australian council as funder.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:nhlbi", "owner": "cardio", "slug": "nhlbi", "name": "National Heart, Lung, and Blood Institute", "aliases": [ "NHLBI" ], "atlases": [ "cardio" ], "summary_plain": "The US government institute that funds heart, lung and blood research.", "summary_technical": "NIH institute. Lead sponsor of SPRINT according to the paper and to ClinicalTrials.gov NCT01206062.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "part_of", "object": "cardio:nih", "claim": null, "label": "An institute of the NIH" } ], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:nhmrc", "owner": "cardio", "slug": "nhmrc", "name": "National Health and Medical Research Council of Australia", "aliases": [ "NHMRC" ], "atlases": [ "cardio" ], "summary_plain": "An Australian research funder named by the SSaSS paper as its funder.", "summary_technical": "Named in the SSaSS abstract as the funder.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:nia", "owner": "cardio", "slug": "nia", "name": "National Institute on Aging", "aliases": [ "NIA" ], "atlases": [ "cardio" ], "summary_plain": "A US government institute that funds research on aging.", "summary_technical": "NIH institute. SPRINT co-sponsor according to the paper and the registry.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "part_of", "object": "cardio:nih", "claim": null, "label": "An institute of the NIH" } ], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:nice", "owner": "cardio", "slug": "nice", "name": "National Institute for Health and Care Excellence", "aliases": [ "NICE" ], "atlases": [ "cardio" ], "summary_plain": "The organization that publishes the NICE guidelines, including the guideline on high blood pressure in adults.", "summary_technical": "Issuer of guideline NG136. This atlas does not yet record its regulatory role or jurisdiction.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "institution" ] } }, { "id": "cardio:niddk", "owner": "cardio", "slug": "niddk", "name": "National Institute of Diabetes and Digestive and Kidney Diseases", "aliases": [ "NIDDK" ], "atlases": [ "cardio" ], "summary_plain": "A US government institute that funds research on diabetes, digestion and kidney disease.", "summary_technical": "NIH institute. SPRINT co-sponsor according to the paper and the registry.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "part_of", "object": "cardio:nih", "claim": null, "label": "An institute of the NIH" } ], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:nih", "owner": "cardio", "slug": "nih", "name": "National Institutes of Health", "aliases": [ "NIH" ], "atlases": [ "cardio" ], "summary_plain": "The National Institutes of Health, named as the funder of the SPRINT trial. The NHLBI, NIDDK, NINDS and NIA are among its institutes.", "summary_technical": "Named as SPRINT's funder in the abstract of the primary report.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:ninds", "owner": "cardio", "slug": "ninds", "name": "National Institute of Neurological Disorders and Stroke", "aliases": [ "NINDS" ], "atlases": [ "cardio" ], "summary_plain": "A US government institute that funds brain and nervous-system research.", "summary_technical": "NIH institute. SPRINT co-sponsor according to the paper and the registry.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "part_of", "object": "cardio:nih", "claim": null, "label": "An institute of the NIH" } ], "navigation": null, "kind": "organization", "payload": { "roles": [ "funder" ] } }, { "id": "cardio:omron-healthcare", "owner": "cardio", "slug": "omron-healthcare", "name": "Omron Healthcare, Inc.", "aliases": [ "Omron Healthcare" ], "atlases": [ "cardio" ], "summary_plain": "The company named as the applicant on the 2000 US FDA clearance of the Omron HEM-907 blood pressure monitor. This page records the name as the FDA gives it. It does not say how the company relates to the Japanese company Omron Healthcare Co., Ltd.", "summary_technical": "FDA records K001848 (HEM-907) and K032305 (HEM-907XL) both name Omron Healthcare, Inc. as the applicant. The Research Organization Registry record 05jy5pk94 is for OMRON Healthcare Co., Ltd., based in Japan, and lists Omron Healthcare, Inc. as an alias of that company. The registry record therefore does not separate the two names. This atlas does not state whether they are one legal entity, so the registry identifier is not attached to this page. Manufacturing is not stated in the sources read: FDA names the company only as the 510(k) applicant.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "company" ] } }, { "id": "cardio:wake-forest-health-sciences", "owner": "cardio", "slug": "wake-forest-health-sciences", "name": "Wake Forest University Health Sciences", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "A US academic health center listed as a SPRINT collaborator.", "summary_technical": "Registry collaborator for NCT01206062 and the affiliation of the coordinating-center principal investigator, who is the registry responsible party.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "institution" ] } }, { "id": "cardio:who", "owner": "cardio", "slug": "who", "name": "World Health Organization", "aliases": [ "WHO" ], "atlases": [ "cardio" ], "summary_plain": "The World Health Organization, which publishes the three guidelines this atlas records: on medicines for high blood pressure in adults (2021), on lower-sodium salt substitutes (2025) and on sodium intake (2012).", "summary_technical": "Issuer of three guidelines recorded in this atlas: Guideline for the pharmacological treatment of hypertension in adults (2021, cardio:who-2021-hypertension-pharmacological), Use of lower-sodium salt substitutes: WHO guideline (2025, cardio:who-2025-lsss) and Guideline: Sodium intake for adults and children (2012, cardio:who-sodium-2012). Each document names the World Health Organization as its publisher or issuer. The institution role is a placeholder that the schema requires.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "organization", "payload": { "roles": [ "institution" ] } }, { "id": "cardio:outcome-sprint-acs-not-mi", "owner": "cardio", "slug": "outcome-sprint-acs-not-mi", "name": "Acute coronary syndrome not resulting in myocardial infarction (SPRINT component)", "aliases": [ "Acute coronary syndrome" ], "atlases": [ "cardio" ], "summary_plain": "A sudden heart-artery problem that did not lead to a heart attack. In SPRINT it is one of the five kinds of event that made up the primary combined outcome.", "summary_technical": "One of the five components of cardio:outcome-sprint-primary-composite, worded as the paper's Methods words it. The paper's main text gives no definition and points to its Supplementary Appendix, which this atlas has not read. Table 2 of the paper and the registry's primary outcome measure use the shorter wording acute coronary syndrome, which is kept as an alias.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "Acute coronary syndrome not resulting in myocardial infarction, as the SPRINT paper's Methods names it among the primary outcome events. The trial's detailed definition is in the paper's Supplementary Appendix, which this atlas has not read.", "unit": "patients", "components": [] } }, { "id": "cardio:outcome-sprint-acute-decompensated-heart-failure", "owner": "cardio", "slug": "outcome-sprint-acute-decompensated-heart-failure", "name": "Acute decompensated heart failure (SPRINT component)", "aliases": [ "Heart failure" ], "atlases": [ "cardio" ], "summary_plain": "A sudden worsening of heart failure. In SPRINT it is one of the five kinds of event that made up the primary combined outcome.", "summary_technical": "One of the five components of cardio:outcome-sprint-primary-composite, worded as the paper's Methods words it. The paper's main text gives no definition and points to its Supplementary Appendix, which this atlas has not read. Table 2 of the paper and the registry's primary outcome measure use the shorter wording heart failure, which is kept as an alias.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "Acute decompensated heart failure, as the SPRINT paper's Methods names it among the primary outcome events. The trial's detailed definition is in the paper's Supplementary Appendix, which this atlas has not read.", "unit": "patients", "components": [] } }, { "id": "cardio:outcome-sprint-cv-death", "owner": "cardio", "slug": "outcome-sprint-cv-death", "name": "Death from cardiovascular causes (SPRINT component)", "aliases": [ "CVD death" ], "atlases": [ "cardio" ], "summary_plain": "Death from heart or blood-vessel causes. In SPRINT it is one of the five kinds of event that made up the primary combined outcome.", "summary_technical": "One of the five components of cardio:outcome-sprint-primary-composite, worded as the paper's Methods words it. The paper's main text gives no definition and points to its Supplementary Appendix, which this atlas has not read. It counts only deaths from cardiovascular causes, so it is not the same outcome as core:outcome-death-any-cause, which SPRINT reports separately. The registry's primary outcome measure calls it CVD Death, which is kept as an alias.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "Death from cardiovascular causes, as the SPRINT paper's Methods names it among the primary outcome events. The trial's detailed definition is in the paper's Supplementary Appendix, which this atlas has not read.", "unit": "patients", "components": [] } }, { "id": "cardio:outcome-sprint-myocardial-infarction", "owner": "cardio", "slug": "outcome-sprint-myocardial-infarction", "name": "Myocardial infarction (SPRINT component)", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "A heart attack. In SPRINT it is one of the five kinds of event that made up the primary combined outcome.", "summary_technical": "One of the five components of cardio:outcome-sprint-primary-composite, worded as the paper's Methods words it. The paper's main text gives no definition and points to its Supplementary Appendix, which this atlas has not read.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "Myocardial infarction, as the SPRINT paper's Methods names it among the primary outcome events. The trial's detailed definition is in the paper's Supplementary Appendix, which this atlas has not read.", "unit": "patients", "components": [] } }, { "id": "cardio:outcome-sprint-primary-composite", "owner": "cardio", "slug": "outcome-sprint-primary-composite", "name": "SPRINT primary composite cardiovascular outcome", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "A combined count of heart attacks, other sudden heart-artery problems, strokes, heart failure and deaths from heart or blood-vessel causes.", "summary_technical": "First occurrence of any component. Adjudicated by assessors who did not know the assignment. The abstract and the registry use shorter wording than the paper's Methods.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": null, "kind": "outcome", "payload": { "definition": "First occurrence of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes (paper, Methods)", "unit": "patients", "components": [ "cardio:outcome-sprint-myocardial-infarction", "cardio:outcome-sprint-acs-not-mi", "core:outcome-stroke", "cardio:outcome-sprint-acute-decompensated-heart-failure", "cardio:outcome-sprint-cv-death" ] } }, { "id": "cardio:bruce-neal", "owner": "cardio", "slug": "bruce-neal", "name": "Bruce Neal", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "Bruce Neal is a medical researcher whose public ORCID record lists a post, with no end date, at The George Institute for Global Health in Sydney (the record's address reads Sydney, NSW, AU). The record says he has particular experience in high blood pressure and diabetes research. The ClinicalTrials.gov record of the SSaSS salt-substitute trial lists Bruce C Neal at The George Institute for Global Health, Australia, as one of several principal investigators, and the PubMed record of the trial's main report names Bruce Neal as its first author. These records are tied to the ORCID record by name and institution only, because none of them gives an identifier that another one shares. This page holds only his public professional identity.", "summary_technical": "ORCID iD 0000-0002-0490-7465. The ORCID employment entry reads Senior Professorial Fellow, Professorial Unit, The George Institute for Global Health/UNSW, from 2019-06-01. Only public professional identity from ORCID is recorded. ClinicalTrials.gov NCT02092090 (source cardio:ssass-ctgov) lists Bruce C Neal, PhD, with the affiliation The George Institute for Global Health, Australia, and the role Principal Investigator, first among several officials listed with that role. It gives no dates for the role. The PubMed record of the SSaSS main report (source cardio:ssass-nejm-2021, PMID 34459569) lists Bruce Neal first among the authors. Neither record gives an ORCID iD for him, so the match with the ORCID record above rests on the name and the institution.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "orcid", "value": "0000-0002-0490-7465" } ], "relationships": [], "navigation": null, "kind": "person", "payload": { "expertise": [ "High blood pressure and diabetes research, as the public ORCID biography states" ], "affiliations": [ { "organization": "core:george-institute", "role": "Senior Professorial Fellow (ORCID employment entry, Professorial Unit)", "from": "2019-06-01", "to": null }, { "organization": "core:george-institute", "role": "Principal investigator of the SSaSS trial, as its ClinicalTrials.gov record lists him (one of several listed)", "from": null, "to": null } ] } }, { "id": "cardio:omron-hem-907", "owner": "cardio", "slug": "omron-hem-907", "name": "Omron HEM-907 blood pressure monitor", "aliases": [ "HEM-907", "Omron IntelliSense blood pressure monitor, model HEM-907" ], "atlases": [ "cardio" ], "summary_plain": "An electronic blood pressure monitor, the Omron HEM-907. The US Food and Drug Administration cleared it in 2000. The FDA record names Omron Healthcare, Inc. only as the applicant for that clearance and does not say who makes the monitor. A 2002 study of 33 people reported that it passed the test protocol the authors used. The FDA record does not say who the monitor is for or where it is used. STRIDE BP, an expert group that keeps lists of blood pressure monitors, has its own page for this model on its website. This atlas names and links that resource (see the STRIDE BP page) and does not restate its content, which is the group's own classification and not a finding of the FDA. Neither a clearance nor passing a test protocol tells you how accurate a monitor is for every person or in everyday use.", "summary_technical": "Listed in FDA 510(k) K001848 as OMRON INTELLISENSE BLOOD PRESSURE MONITOR, MODEL HEM-907, decided 2000-07-03, product code DXN, device class 2, clearance type Special. The record is a Statement and gives no indications-for-use text. FDA's device type for the code is System, Measurement, Blood-Pressure, Non-Invasive. A 2002 paper (abstract only) reports that the device passed both phases of the international validation protocol in 33 people. FDA also lists a separate model, HEM-907XL, under K032305 (decided 2004-02-11). The SPRINT trial paper names its automated measurement system as \"Model 907, Omron Healthcare\" and does not say which variant. This atlas does not state which one SPRINT used. The STRIDE BP website has a page for this model. STRIDE BP's terms do not allow its content to be reproduced, so this atlas names and links that resource (see the STRIDE BP page) and restates none of its classification.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [ { "predicate": "related_to", "object": "core:automated-upper-arm-cuff-device", "claim": null, "label": "FDA product code DXN" }, { "predicate": "related_to", "object": "cardio:omron-healthcare", "claim": null, "label": "Applicant named on the 2000 FDA clearance; the sources read do not say who makes the monitor" }, { "predicate": "related_to", "object": "cardio:stride-bp-validated-device-lists", "claim": null, "label": "STRIDE BP has its own page for this model; its content is not restated here" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "product", "payload": { "subtype": "device", "model_or_formulation": "HEM-907", "version": "Not stated in the sources read. FDA lists a separate model, HEM-907XL, under its own number.", "intended_use_snapshots": [] } }, { "id": "cardio:pub-aha-acc-2025-hbp", "owner": "cardio", "slug": "pub-aha-acc-2025-hbp", "name": "2025 AHA/ACC high blood pressure guideline", "aliases": [ "2025 AHA/ACC guideline for high blood pressure in adults" ], "atlases": [ "cardio" ], "summary_plain": "The 2025 guideline from the American Heart Association and the American College of Cardiology, with other societies, on preventing, detecting, evaluating and managing high blood pressure in adults. Its abstract says it replaces the 2017 guideline. Only the abstract could be read, so this page does not give the guideline's thresholds, targets or recommendations.", "summary_technical": "Circulation 2025;152(11):e114-e218. doi:10.1161/CIR.0000000000001356. PMID 40811497. Issued as a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, with other societies named in the title. Co-published in JACC 86(18):1567-1678, doi:10.1016/j.jacc.2025.05.007. Publisher pages returned HTTP 403, so this is a publication identity with one descriptive claim. Three corrections to the Circulation version are listed in PubMed, and their text was not read.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "doi", "value": "10.1161/CIR.0000000000001356" }, { "namespace": "pmid", "value": "40811497" } ], "relationships": [ { "predicate": "authored_by", "object": "core:aha", "claim": null, "label": "Co-issuer, with the American College of Cardiology" }, { "predicate": "authored_by", "object": "core:acc", "claim": null, "label": "Co-issuer, with the American Heart Association" } ], "navigation": { "cardio": { "condition-area": [ "hypertension" ] } }, "kind": "publication", "payload": { "source": "cardio:aha-acc-2025-hbp", "publication_type": "guideline", "plain_interpretation": null } }, { "id": "cardio:pub-bplttc-lancet-2021", "owner": "cardio", "slug": "pub-bplttc-lancet-2021", "name": "BPLTTC individual-participant meta-analysis, Lancet 2021", "aliases": [ "Blood Pressure Lowering Treatment Trialists' Collaboration 2021" ], "atlases": [ "cardio" ], "summary_plain": "A large analysis that pooled the original patient-level data from 48 randomised trials of blood-pressure-lowering medicines, 344,716 people in all. It asked whether the medicines lower the risk of strokes, heart attacks and heart failure both in people who have already had a stroke, a heart attack or ischaemic heart disease and in people who have not, and at different starting blood pressures. The authors report a similar proportional benefit in both groups.", "summary_technical": "The Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet 2021;397(10285):1625-1636. doi:10.1016/S0140-6736(21)00590-0. PMID 33933205. PMC8102467 (open access, CC BY 4.0). PubMed type: Meta-Analysis. A one-stage individual-participant analysis with stratified Cox proportional hazard models; the primary outcome is a major cardiovascular event. This page is a publication record, not a study: it links none of the trials it pools. The one erratum (doi:10.1016/S0140-6736(21)01069-2, PMID 34022983) only updates the collaboration group list. Figure 3 (component outcomes, including stroke alone) is an image that was not read, so no component result is recorded.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "doi", "value": "10.1016/S0140-6736(21)00590-0" }, { "namespace": "pmid", "value": "33933205" }, { "namespace": "pmcid", "value": "PMC8102467" } ], "relationships": [ { "predicate": "published_in", "object": "core:lancet", "claim": null, "label": "Published in" } ], "navigation": { "cardio": { "condition-area": [ "hypertension", "risk-and-prevention" ] } }, "kind": "publication", "payload": { "source": "cardio:bplttc-lancet-2021", "publication_type": "article", "plain_interpretation": "The authors read the result as saying that the proportional benefit followed the size of the blood pressure fall, whether or not a person already had a stroke, heart attack or ischaemic heart disease, and even at normal or high-normal readings. That is the authors' interpretation. It has not been independently assessed here." } }, { "id": "cardio:pub-esc-2024-hypertension", "owner": "cardio", "slug": "pub-esc-2024-hypertension", "name": "2024 ESC guidelines on elevated blood pressure and hypertension", "aliases": [ "2024 ESC Guidelines for the management of elevated blood pressure and hypertension" ], "atlases": [ "cardio" ], "summary_plain": "The 2024 guideline from the European Society of Cardiology on elevated blood pressure and hypertension. It updates the society's 2018 guideline, which it issued with the European Society of Hypertension. The only text that could be read was the ESC's own short summary of key messages. Two claims drawn from that summary, on the new elevated-blood-pressure category and on the treatment target, are shown on the pages for blood pressure and for lowering blood pressure to a target. The full guideline was not read.", "summary_technical": "Eur Heart J 2024;45(38):3912-4018. doi:10.1093/eurheartj/ehae178. PMID 39210715. Published 30 August 2024 (ESC page); the PubMed issue date is 2024-10-07. PubMed type: Practice Guideline, with no abstract. Two corrections are listed in PubMed (doi:10.1093/eurheartj/ehaf031 and doi:10.1093/eurheartj/ehaf659) and their text was not read. This page links no record for the journal or the society, so it has no published_in or authored_by link. The two claims drawn from the summary have the subjects core:blood-pressure and cardio:bp-lowering-to-target, so they appear on those pages and not on this one.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "doi", "value": "10.1093/eurheartj/ehae178" }, { "namespace": "pmid", "value": "39210715" } ], "relationships": [], "navigation": { "cardio": { "condition-area": [ "hypertension" ] } }, "kind": "publication", "payload": { "source": "cardio:esc-2024-hypertension", "publication_type": "guideline", "plain_interpretation": null } }, { "id": "cardio:pub-nice-ng136", "owner": "cardio", "slug": "pub-nice-ng136", "name": "NICE guideline NG136: Hypertension in adults, diagnosis and management", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "The NICE guideline on diagnosing and treating high blood pressure in adults, with the dates of its changes.", "summary_technical": "NICE guideline NG136, published 28 August 2019 and last updated 26 February 2026 on the pages fetched on 2026-10-11. The February 2026 update added recommendation 1.2.11, which offers healthy-living advice to people with raised blood pressure who are not diagnosed with hypertension. The Overview chapter says NICE is following ongoing research into how different ethnic groups respond to blood-pressure drugs and will decide whether to update the guideline. NICE has a separate guideline on hypertension in pregnancy. Recommendations tagged with 2019 are those NICE made in August 2019 after reviewing the evidence. NICE gives no strength label; it signals strength by verbs such as offer and consider. NICE says it does not write its content as a basis for decisions outside the United Kingdom. Reuse is licensed in the United Kingdom only; outside it, apart from private use, study or one's own research, NICE's written agreement is needed and may carry a licence and fee, and use for artificial intelligence needs approval and a licence arrangement. This atlas states NICE's recommendations in its own words, with a citation and a link, because of these reuse terms.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "nice", "value": "NG136" } ], "relationships": [ { "predicate": "authored_by", "object": "cardio:nice", "claim": null, "label": "Issuer" } ], "navigation": { "cardio": { "condition-area": [ "hypertension" ] } }, "kind": "publication", "payload": { "source": "cardio:nice-ng136", "publication_type": "guideline", "plain_interpretation": null } }, { "id": "cardio:pub-sprint-nejm-2015", "owner": "cardio", "slug": "pub-sprint-nejm-2015", "name": "SPRINT primary results, NEJM 2015", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "The main report of the SPRINT trial results, published in November 2015.", "summary_technical": "SPRINT Research Group. N Engl J Med 2015;373:2103-16. doi:10.1056/NEJMoa1511939. PMID 26551272. PubMed links a 2017 erratum (doi:10.1056/NEJMx170008, PMID 29262284). What the erratum corrects was not verified.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "doi", "value": "10.1056/NEJMoa1511939" }, { "namespace": "pmid", "value": "26551272" }, { "namespace": "pmcid", "value": "PMC4689591" } ], "relationships": [ { "predicate": "published_in", "object": "core:nejm", "claim": null, "label": "Published in" } ], "navigation": null, "kind": "publication", "payload": { "source": "cardio:sprint-nejm-2015", "publication_type": "article", "plain_interpretation": null } }, { "id": "cardio:pub-ssass-nejm-2021", "owner": "cardio", "slug": "pub-ssass-nejm-2021", "name": "SSaSS main results, NEJM 2021", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "The main report of the SSaSS salt-substitute trial, published online on 29 August 2021 and in the print issue of 16 September 2021.", "summary_technical": "N Engl J Med 2021;385(12):1067-1077, in the issue dated 16 September 2021. PubMed gives an electronic publication date of 29 August 2021. doi:10.1056/NEJMoa2105675. PMID 34459569. Title: Effect of Salt Substitution on Cardiovascular Events and Death. This record rests on the PubMed abstract. The version of record returned HTTP 403, and Europe PMC reports the article as not open access and not in PMC.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [ { "namespace": "doi", "value": "10.1056/NEJMoa2105675" }, { "namespace": "pmid", "value": "34459569" } ], "relationships": [ { "predicate": "published_in", "object": "core:nejm", "claim": null, "label": "Published in" }, { "predicate": "authored_by", "object": "cardio:bruce-neal", "claim": null, "label": "First author listed in PubMed" } ], "navigation": { "cardio": { "system": [ "brain" ], "condition-area": [ "risk-and-prevention", "stroke" ] } }, "kind": "publication", "payload": { "source": "cardio:ssass-nejm-2021", "publication_type": "article", "plain_interpretation": null } }, { "id": "cardio:pub-who-2021-hypertension-pharmacological", "owner": "cardio", "slug": "pub-who-2021-hypertension-pharmacological", "name": "WHO guideline for the pharmacological treatment of hypertension in adults (2021)", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "The 2021 World Health Organization guideline on when to start blood pressure medicine in adults, which medicines to start with, which targets to aim for and who can provide the care.", "summary_technical": "Published 24 August 2021 (WHO publication page), ISBN 978-92-4-003398-6 (electronic version), licence CC BY-NC-SA 3.0 IGO. The publication page gives 48 pages and the PDF has 61, which this cluster did not resolve. WHO says the recommendations target adult, non-pregnant patients who were appropriately diagnosed with hypertension and counselled about lifestyle changes, and that it graded the evidence with the GRADE approach. This atlas records recommendations 1, 4, 5, 6 and 8, each statement with its own strength label. Recommendations 2, 3 and 7 were not read. Whether a later WHO edition replaces this guideline was not checked.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "isbn", "value": "978-92-4-003398-6" } ], "relationships": [ { "predicate": "authored_by", "object": "cardio:who", "claim": null, "label": "Issuer" } ], "navigation": { "cardio": { "condition-area": [ "hypertension" ] } }, "kind": "publication", "payload": { "source": "cardio:who-2021-hypertension-pharmacological", "publication_type": "guideline", "plain_interpretation": null } }, { "id": "cardio:reading-path-high-bp", "owner": "cardio", "slug": "reading-path-high-bp", "name": "From a high blood pressure reading to stroke prevention", "aliases": [ "Reading path: high blood pressure" ], "atlases": [ "cardio" ], "summary_plain": "A suggested order for reading this atlas, for an adult who has been told they have a high blood pressure reading, and for their family. It starts with what a reading and a diagnosis mean, goes through measuring at home and on a device you can check, then medicines, salt and stroke, and ends with prevention and questions to take to your care team. It is not medical advice and it does not cover pregnancy.", "summary_technical": "Eleven steps in the order set by the breadth map. Each step explanation restates what the linked page's own records say and adds no claim of its own. Claims keep their own context on their own pages: most are for adults and none is for pregnancy.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "relationships": [], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension", "risk-and-prevention" ] } }, "kind": "reading_path", "payload": { "audience": "Adults who have been told they have a high blood pressure reading, and their families. It does not cover pregnancy.", "steps": [ { "entity": "core:hypertension", "explanation": "High blood pressure, called hypertension, means blood pressure that stays higher than it should over time. Guidelines set different thresholds, so each number in this atlas is tied to the guideline that gives it." }, { "entity": "core:blood-pressure", "explanation": "Blood pressure is how hard the blood pushes on the arteries and other blood vessels. A device reports two values, a systolic one and a diastolic one. This page shows what two guidelines say about the numbers. NICE confirms a diagnosis in adults when the clinic reading is 140/90 mmHg or higher and the daytime ambulatory average or the home average is 135/85 mmHg or higher. The European Society of Cardiology's summary adds a category called elevated blood pressure. The two are shown side by side and are not merged. NICE says its content is not meant as a basis for decisions outside the United Kingdom." }, { "entity": "cardio:ambulatory-bp-monitoring", "explanation": "Ambulatory blood pressure monitoring means taking repeated readings through your usual waking hours. NICE recommends offering it to confirm a diagnosis in adults whose clinic reading is between 140/90 and 180/120 mmHg. NICE does not say it is the only or best way to confirm the diagnosis." }, { "entity": "core:home-bp-monitoring", "explanation": "Home blood pressure monitoring means measuring your own blood pressure with a device, at home or elsewhere outside the clinic. NICE recommends offering it to confirm a diagnosis when ambulatory monitoring is unsuitable or the person cannot tolerate it." }, { "entity": "core:automated-upper-arm-cuff-device", "explanation": "This is a device with a cuff for the upper arm that works out the reading itself from signals in the cuff. Even a validated device has to be used in a standard way, for example with a cuff of the right size, at heart level, on a bare upper arm. NICE puts a duty on healthcare providers: every blood pressure device they use must be properly validated, kept in working order and recalibrated on a regular schedule. The NICE text does not say what properly validated means." }, { "entity": "cardio:stride-bp-validated-device-lists", "explanation": "STRIDE BP is a group that keeps lists of validated blood pressure monitors on its own website. This atlas names and links that resource and does not restate what it lists. You can search it for a monitor. Not being on a list does not by itself show that a monitor is inaccurate." }, { "entity": "cardio:idea-cuffless-bp-monitoring", "explanation": "Many devices that measure blood pressure without an inflating cuff are on sale, and they claim to be accurate. A 2022 statement from a European hypertension expert group says recent European Society of Hypertension guidelines do not recommend them for diagnosis or management, and that questions about their accuracy must be answered first. A 2023 statement sets out six validation tests. This page does not say that any such device is accurate." }, { "entity": "cardio:bp-lowering-medicine", "explanation": "For adults whose high blood pressure is confirmed, WHO recommends that those who need medicine start with a drug from one of three classes: thiazide and thiazide-like agents, ACE inhibitors or angiotensin-receptor blockers, or long-acting dihydropyridine calcium channel blockers. WHO also suggests starting with a combination of these drugs, preferably in a single pill. The page shows both statements and the pressures at which WHO says to start medicine. It also shows a pooled analysis of 48 trials, which found that a 5 mm Hg lower systolic pressure from treatment went with a lower risk of a major cardiovascular event. The analysis says nothing about one drug or about benefit for one person." }, { "entity": "cardio:salt-substitution", "explanation": "A salt substitute swaps part of the sodium in table salt for potassium. In SSaSS, a trial in rural China among people who had had a stroke or were 60 or older with high blood pressure, villages that used a substitute had fewer strokes and fewer deaths than villages that kept regular salt. WHO suggests that adults in general populations who use table salt could replace it with a potassium-containing substitute. WHO says this is not intended for pregnant women, children, or people with kidney impairment or other conditions that might make it harder to clear potassium. NICE says older people, people with diabetes, people with kidney disease, and people on some blood-pressure medicines (for example ACE inhibitors and angiotensin II receptor blockers) should not use salt substitutes that contain potassium chloride, and says these groups should be encouraged to cut down on salt instead. The two bodies name different groups, and their positions are shown side by side and are not merged." }, { "entity": "core:stroke", "explanation": "A stroke is a sudden loss of brain function. It happens when part of the brain does not get enough blood or when there is bleeding inside the skull. A 2012 WHO guideline describes high blood pressure as a major risk factor for cardiovascular disease, in particular for heart attack and stroke. It does not say that lowering blood pressure prevents stroke. This page also lists the SSaSS salt-substitute trial, which counted strokes." }, { "entity": "cardio:cardiovascular-prevention", "explanation": "This is the starting page for the atlas's prevention material. So far it is built around blood pressure, and it holds one piece of evidence, the pooled analysis of blood-pressure-lowering medicines shown on the medicine page. Questions you could take to your care team: What blood pressure target applies to me? How often should I check at home? Is a potassium salt substitute safe for me? They are questions, not advice, and this atlas does not give the answers." } ] } }, { "id": "cardio:stride-bp-validated-device-lists", "owner": "cardio", "slug": "stride-bp-validated-device-lists", "name": "STRIDE BP validated device lists", "aliases": [ "STRIDE BP validated devices lists" ], "atlases": [ "cardio" ], "summary_plain": "STRIDE BP is a group that keeps lists of validated blood pressure monitors on its website, https://www.stridebp.org/. Its terms do not allow its content to be copied into another site, so this atlas names and links the resource and does not restate what it lists or how it chooses. Not being on a list does not by itself show that a monitor is inaccurate.", "summary_technical": "A pointer to an outside resource, kept as a name and a link only. This atlas does not restate STRIDE BP's lists, listing rules or counts. The Omron HEM-907 product page links here because STRIDE BP has its own page for that model.", "editorial_state": "draft", "last_substantive_edit": "2026-10-13", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [], "relationships": [], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "resource", "payload": { "resource_type": "collection", "owner": null, "contents": "Lists of validated blood pressure monitors, kept by STRIDE BP.", "access": "Free public website: https://www.stridebp.org/.", "license": "All rights reserved by STRIDE BP, and its terms of use do not allow its content to be copied into another site. This atlas names and links the resource and does not quote or restate its content." } }, { "id": "cardio:high-sodium-intake", "owner": "cardio", "slug": "high-sodium-intake", "name": "High sodium intake", "aliases": [ "High salt intake" ], "atlases": [ "cardio" ], "summary_plain": "Sodium is the part of table salt linked with higher blood pressure when people eat a lot of it. The World Health Organization advises adults to keep sodium below 2 grams a day, which is about 5 grams of salt. It estimated that average sodium intake worldwide in 2019 was more than double that limit.", "summary_technical": "Exposure defined here as dietary sodium above the WHO limit of less than 2 g a day of sodium (5 g of salt) in adults, a strong WHO recommendation. The MeSH heading \"Sodium Chloride, Dietary\" names the substance, not an intake level. Evidence recorded here is the WHO 2012 summary of observational associations (very low to low quality ratings) and the WHO 2025 restatement of the limit. The WHO 2012 text also reports an association with hypertension, recorded as a discovery link because the passage does not state raised risk. SSaSS tested a different thing: replacing salt with a potassium-containing substitute.", "editorial_state": "draft", "last_substantive_edit": "2026-10-11", "last_evidence_check": "2026-10-11", "next_review_due": null, "external_ids": [ { "namespace": "mesh", "value": "D017673" } ], "relationships": [ { "predicate": "increases_risk_of", "object": "core:stroke", "claim": "cardio:claim-high-sodium-raises-stroke-risk", "label": "Observational association with stroke (WHO 2012, quality very low to low)" }, { "predicate": "related_to", "object": "core:hypertension", "claim": null, "label": "Discussed together in the WHO 2012 sodium guideline" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "risk-and-prevention", "hypertension", "stroke" ] } }, "kind": "risk_factor", "payload": { "factor_type": "exposure", "definition": "Dietary sodium intake above the WHO limit for adults of less than 2 g of sodium (5 g of salt) a day.", "contexts": [ "cardio:ctx-who-adults-sodium-intake" ] } }, { "id": "cardio:sprint", "owner": "cardio", "slug": "sprint", "name": "Systolic Blood Pressure Intervention Trial (SPRINT)", "aliases": [ "SPRINT" ], "atlases": [ "cardio" ], "summary_plain": "A large US trial that compared aiming for a top blood-pressure number below 120 with aiming below 140 in adults aged 50 and over at higher heart risk who did not have diabetes or a past stroke.", "summary_technical": "NHLBI-sponsored, open-label randomized trial (NCT01206062) of 9361 adults comparing systolic targets below 120 and below 140 mm Hg. The composite cardiovascular primary outcome was adjudicated blind to assignment. The blood-pressure intervention was stopped early for benefit in 2015. Azilsartan and azilsartan with chlorthalidone were donated by Takeda and Arbor; the paper says neither company had any other role.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [ { "namespace": "nct", "value": "NCT01206062" } ], "relationships": [ { "predicate": "investigates", "object": "cardio:intensive-sbp-lowering", "claim": null, "label": "Tests the intensive systolic target" }, { "predicate": "investigates", "object": "core:hypertension", "claim": null, "label": "Enrolled adults with raised systolic blood pressure" }, { "predicate": "sponsored_by", "object": "cardio:nhlbi", "claim": null, "label": "Lead sponsor" }, { "predicate": "sponsored_by", "object": "cardio:niddk", "claim": null, "label": "Co-sponsor" }, { "predicate": "sponsored_by", "object": "cardio:ninds", "claim": null, "label": "Co-sponsor" }, { "predicate": "sponsored_by", "object": "cardio:nia", "claim": null, "label": "Co-sponsor" }, { "predicate": "funded_by", "object": "cardio:nih", "claim": null, "label": "Funder named in the abstract" }, { "predicate": "related_to", "object": "cardio:wake-forest-health-sciences", "claim": null, "label": "Registry collaborator and coordinating-center affiliation" }, { "predicate": "results_reported_in", "object": "cardio:pub-sprint-nejm-2015", "claim": null, "label": "Primary results, NEJM 2015" } ], "navigation": { "cardio": { "system": [ "blood-vessels" ], "condition-area": [ "hypertension" ] } }, "kind": "study", "payload": { "design": "Randomized, parallel-group, open-label trial with blinded outcome adjudication at 102 clinical sites in 5 clinical-center networks in the United States including Puerto Rico. The registry records allocation as randomized and masking as single (outcomes assessor).", "drug_phase": "not_applicable", "registry_statuses": [ { "status": "COMPLETED", "snapshot": "cardio:ctgov-nct01206062-2026-10-09" } ], "start_date": { "date": "2010-10", "type": "actual", "snapshot": "cardio:ctgov-nct01206062-2026-10-09" }, "primary_completion_date": { "date": "2016-07", "type": "actual", "snapshot": "cardio:ctgov-nct01206062-2026-10-09" }, "completion_date": { "date": "2019-03", "type": "actual", "snapshot": "cardio:ctgov-nct01206062-2026-10-09" }, "countries": [ { "code": "US", "snapshot": "cardio:ctgov-nct01206062-2026-10-09" } ], "care_setting": { "description": "Outpatient trial clinics at 102 clinical sites in 5 clinical-center networks in the United States, including Puerto Rico. Nursing-home and assisted-living residents were not enrolled.", "snapshot": "cardio:pmc-pmc4689591-2026-10-09" }, "stopped_early": { "scope": "intervention", "date": "2015-08-20", "reason": "The NHLBI director accepted the data and safety monitoring board recommendation, made after analyses of the primary outcome crossed the monitoring boundary at two consecutive time points. The registry records the trial itself as completed.", "snapshot": "cardio:pmc-pmc4689591-2026-10-09" }, "enrollment": [ { "count": 9361, "basis": "randomized", "unit": "participants", "snapshot": "cardio:pubmed-26551272-2026-10-09" } ], "arms": [ { "id": "cardio:sprint-arm-intensive", "label": "Intensive treatment", "intervention": "cardio:intensive-sbp-lowering", "description": "Systolic target below 120 mm Hg, with medicines adjusted monthly toward the target. The registry says most participants started on two drugs and another drug was required at milepost visits if not at goal. Mean of 2.8 blood-pressure medicines over follow-up." }, { "id": "cardio:sprint-arm-standard", "label": "Standard treatment", "intervention": null, "description": "Systolic target below 140 mm Hg (abstract and registry). The paper says medicines were adjusted toward 135 to 139 mm Hg, with a dose reduction below 130 at one visit or below 135 at two consecutive visits. Mean of 1.8 medicines. Both arms used the same study formulary. No separate intervention entity is recorded for this comparator strategy." } ], "findings": [ { "id": "cardio:f-sprint-primary-intensive", "outcome_id": "cardio:outcome-sprint-primary-composite", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-intensive", "comparator_arm_id": null, "claim_id": "cardio:claim-sprint-primary-effect", "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "endpoint_role": "primary", "effect_measure": "participants with at least one primary outcome event (count)", "numeric_value": 243, "reported_text": "243 (5.2%), 1.65% per year", "unit": "participants", "denominator": 4678, "denominator_status": null, "denominator_basis": "All participants randomized to the arm (Table 2 \"All participants\" N, intention to treat). The registry outcome denominator is the same.", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": "not_applicable" }, { "id": "cardio:f-sprint-primary-standard", "outcome_id": "cardio:outcome-sprint-primary-composite", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-standard", "comparator_arm_id": null, "claim_id": "cardio:claim-sprint-primary-effect", "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "endpoint_role": "primary", "effect_measure": "participants with at least one primary outcome event (count)", "numeric_value": 319, "reported_text": "319 (6.8%), 2.19% per year", "unit": "participants", "denominator": 4683, "denominator_status": null, "denominator_basis": "All participants randomized to the arm (Table 2 \"All participants\" N, intention to treat). The registry outcome denominator is the same.", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": "not_applicable" }, { "id": "cardio:f-sprint-primary-hr", "outcome_id": "cardio:outcome-sprint-primary-composite", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-intensive", "comparator_arm_id": "cardio:sprint-arm-standard", "claim_id": "cardio:claim-sprint-primary-effect", "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "endpoint_role": "primary", "effect_measure": "hazard ratio, intensive vs standard (Cox proportional-hazards, stratified by clinic, intention to treat)", "numeric_value": 0.75, "reported_text": "HR 0.75 (95% CI 0.64 to 0.89), P<0.001", "unit": "ratio", "denominator": null, "denominator_status": "not_applicable", "denominator_basis": "Comparison of the two per-arm rows (4678 vs 4683)", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": 0.64, "estimate_upper": 0.89, "interval_method": "two-sided 95% confidence interval", "interval_status": null }, { "id": "cardio:f-sprint-death-intensive", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-intensive", "comparator_arm_id": null, "claim_id": "cardio:claim-sprint-mortality-effect", "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "endpoint_role": "secondary", "effect_measure": "participants who died (count)", "numeric_value": 155, "reported_text": "155 (3.3%), 1.03% per year", "unit": "participants", "denominator": 4678, "denominator_status": null, "denominator_basis": "All participants randomized to the arm (Table 2 \"All participants\" N, intention to treat). The registry outcome denominator is the same.", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": "not_applicable" }, { "id": "cardio:f-sprint-death-standard", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-standard", "comparator_arm_id": null, "claim_id": "cardio:claim-sprint-mortality-effect", "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "endpoint_role": "secondary", "effect_measure": "participants who died (count)", "numeric_value": 210, "reported_text": "210 (4.5%), 1.40% per year", "unit": "participants", "denominator": 4683, "denominator_status": null, "denominator_basis": "All participants randomized to the arm (Table 2 \"All participants\" N, intention to treat). The registry outcome denominator is the same.", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": "not_applicable" }, { "id": "cardio:f-sprint-death-hr", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "arm_id": "cardio:sprint-arm-intensive", "comparator_arm_id": "cardio:sprint-arm-standard", "claim_id": "cardio:claim-sprint-mortality-effect", "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "endpoint_role": "secondary", "effect_measure": "hazard ratio, intensive vs standard", "numeric_value": 0.73, "reported_text": "HR 0.73 (95% CI 0.60 to 0.90), P=0.003", "unit": "ratio", "denominator": null, "denominator_status": "not_applicable", "denominator_basis": "Comparison of the two per-arm rows (4678 vs 4683)", "time_window": "Median 3.26 years of follow-up, to the early stop of the blood-pressure intervention on 2015-08-20", "estimate_lower": 0.6, "estimate_upper": 0.9, "interval_method": "two-sided 95% confidence interval", "interval_status": null } ] } }, { "id": "cardio:ssass", "owner": "cardio", "slug": "ssass", "name": "China Salt Substitute and Stroke Study (SSaSS)", "aliases": [ "SSaSS", "Salt Substitute and Stroke Study" ], "atlases": [ "cardio" ], "summary_plain": "A large trial in rural China that tested whether replacing ordinary salt with a lower-sodium, potassium-enriched salt reduces strokes. It enrolled people who had had a stroke or who were 60 or older with high blood pressure, in 600 villages. Villages were assigned by chance to the salt substitute or to ordinary salt. Over about 4.7 years there were fewer strokes and fewer deaths in the salt-substitute villages. The results apply to this group in rural China and should not be assumed for other people.", "summary_technical": "Open-label (abstract), cluster-randomized trial NCT02092090 in 600 villages, assigned 1:1. Registry enrollment is 20996 and the abstract reports 20,995 enrolled; the reason is unknown. Intervention villages: ongoing dietary advice plus a salt substitute of 75% sodium chloride and 25% potassium chloride by mass; control villages: dietary advice at baseline only (registry) and regular salt (abstract). Primary outcome stroke; secondary outcomes major adverse cardiovascular events (49.09 against 56.29 events per 1000 person-years, rate ratio 0.87, 95% CI 0.80 to 0.94) and death from any cause; safety outcome clinical hyperkalemia. Mean follow-up 4.74 years. Funded by the National Health and Medical Research Council of Australia (abstract). PubMed also lists a grant from the UK Medical Research Council (MR/S019669/1). The registry names The George Institute as lead sponsor. The abstract says open-label while the registry records masking as DOUBLE; not reconciled. No results are posted in the registry. Full text was not accessible, so per-arm event counts and denominators are not recorded.", "editorial_state": "draft", "last_substantive_edit": "2026-10-12", "last_evidence_check": "2026-10-12", "next_review_due": null, "external_ids": [ { "namespace": "nct", "value": "NCT02092090" } ], "relationships": [ { "predicate": "investigates", "object": "cardio:salt-substitution", "claim": null, "label": "Intervention arm" }, { "predicate": "investigates", "object": "core:stroke", "claim": null, "label": "Primary outcome" }, { "predicate": "investigates", "object": "cardio:high-sodium-intake", "claim": null, "label": "Sodium reduction" }, { "predicate": "sponsored_by", "object": "core:george-institute", "claim": null, "label": "Lead sponsor named in the registry" }, { "predicate": "funded_by", "object": "cardio:nhmrc", "claim": null, "label": "Funder named in the abstract" }, { "predicate": "funded_by", "object": "cardio:mrc", "claim": null, "label": "Grant MR/S019669/1 listed by PubMed" }, { "predicate": "results_reported_in", "object": "cardio:pub-ssass-nejm-2021", "claim": null, "label": "Main results, NEJM 2021" } ], "navigation": { "cardio": { "system": [ "brain" ], "condition-area": [ "risk-and-prevention", "stroke" ] } }, "kind": "study", "payload": { "design": "Cluster-randomized, parallel-group trial of 600 villages assigned 1:1. The abstract calls it open-label. The registry records allocation as randomized and masking as DOUBLE (investigator and outcomes assessor). The two descriptions are not reconciled. Prevention trial; no drug phase.", "drug_phase": "not_applicable", "registry_statuses": [ { "status": "COMPLETED", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" } ], "start_date": { "date": "2014-07-09", "type": "actual", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" }, "primary_completion_date": { "date": "2020-09-04", "type": "actual", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" }, "completion_date": { "date": "2020-09-04", "type": "actual", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" }, "countries": [ { "code": "CN", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" } ], "care_setting": { "description": "Rural villages in China, 600 of them according to the abstract.", "snapshot": "cardio:pubmed-34459569-2026-10-11" }, "stopped_early": null, "enrollment": [ { "count": 20996, "basis": "enrolled", "unit": "participants", "snapshot": "cardio:ctgov-nct02092090-2026-10-11" }, { "count": 20995, "basis": "enrolled", "unit": "participants", "snapshot": "cardio:pubmed-34459569-2026-10-11" }, { "count": 600, "basis": "randomized", "unit": "villages", "snapshot": "cardio:pubmed-34459569-2026-10-11" } ], "arms": [ { "id": "cardio:ssass-arm-salt-substitute", "label": "Salt substitute with dietary advice", "intervention": "cardio:salt-substitution", "description": "Villages whose participants used a salt substitute of 75% sodium chloride and 25% potassium chloride by mass (abstract). The registry describes ongoing dietary advice plus a supply of a reduced-sodium added-potassium salt substitute." }, { "id": "cardio:ssass-arm-control", "label": "Regular salt", "intervention": null, "description": "Villages whose participants continued regular salt of 100% sodium chloride (abstract). The registry records dietary advice at baseline only and an arm type of no intervention. No separate intervention entity is recorded for the comparator." } ], "findings": [ { "id": "cardio:f-ssass-stroke-substitute", "outcome_id": "core:outcome-stroke", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-salt-substitute", "comparator_arm_id": null, "claim_id": "cardio:claim-ssass-stroke-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "primary", "effect_measure": "stroke rate (events per 1000 person-years)", "numeric_value": 29.14, "reported_text": "29.14 events per 1000 person-years", "unit": "events per 1000 person-years", "denominator": null, "denominator_status": null, "denominator_basis": "Not reported in the abstract: neither person-years nor event counts are given.", "time_window": "Mean follow-up 4.74 years", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": null }, { "id": "cardio:f-ssass-stroke-control", "outcome_id": "core:outcome-stroke", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-control", "comparator_arm_id": null, "claim_id": "cardio:claim-ssass-stroke-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "primary", "effect_measure": "stroke rate (events per 1000 person-years)", "numeric_value": 33.65, "reported_text": "33.65 events per 1000 person-years", "unit": "events per 1000 person-years", "denominator": null, "denominator_status": null, "denominator_basis": "Not reported in the abstract: neither person-years nor event counts are given.", "time_window": "Mean follow-up 4.74 years", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": null }, { "id": "cardio:f-ssass-stroke-rr", "outcome_id": "core:outcome-stroke", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-salt-substitute", "comparator_arm_id": "cardio:ssass-arm-control", "claim_id": "cardio:claim-ssass-stroke-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "primary", "effect_measure": "rate ratio, salt substitute against regular salt", "numeric_value": 0.86, "reported_text": "rate ratio 0.86 (95% CI 0.77 to 0.96), P = 0.006", "unit": "ratio", "denominator": null, "denominator_status": "not_applicable", "denominator_basis": "Comparison of the two per-arm rate rows", "time_window": "Mean follow-up 4.74 years", "estimate_lower": 0.77, "estimate_upper": 0.96, "interval_method": "95% confidence interval; the abstract does not name the model", "interval_status": null }, { "id": "cardio:f-ssass-death-substitute", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-salt-substitute", "comparator_arm_id": null, "claim_id": "cardio:claim-ssass-mortality-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "secondary", "effect_measure": "death rate from any cause (events per 1000 person-years)", "numeric_value": 39.28, "reported_text": "39.28 events per 1000 person-years", "unit": "events per 1000 person-years", "denominator": null, "denominator_status": null, "denominator_basis": "Not reported in the abstract: neither person-years nor event counts are given.", "time_window": "Mean follow-up 4.74 years", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": null }, { "id": "cardio:f-ssass-death-control", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-control", "comparator_arm_id": null, "claim_id": "cardio:claim-ssass-mortality-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "secondary", "effect_measure": "death rate from any cause (events per 1000 person-years)", "numeric_value": 44.61, "reported_text": "44.61 events per 1000 person-years", "unit": "events per 1000 person-years", "denominator": null, "denominator_status": null, "denominator_basis": "Not reported in the abstract: neither person-years nor event counts are given.", "time_window": "Mean follow-up 4.74 years", "estimate_lower": null, "estimate_upper": null, "interval_method": null, "interval_status": null }, { "id": "cardio:f-ssass-death-rr", "outcome_id": "core:outcome-death-any-cause", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "arm_id": "cardio:ssass-arm-salt-substitute", "comparator_arm_id": "cardio:ssass-arm-control", "claim_id": "cardio:claim-ssass-mortality-effect", "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "endpoint_role": "secondary", "effect_measure": "rate ratio, salt substitute against regular salt", "numeric_value": 0.88, "reported_text": "rate ratio 0.88 (95% CI 0.82 to 0.95), P<0.001", "unit": "ratio", "denominator": null, "denominator_status": "not_applicable", "denominator_basis": "Comparison of the two per-arm rate rows", "time_window": "Mean follow-up 4.74 years", "estimate_lower": 0.82, "estimate_upper": 0.95, "interval_method": "95% confidence interval; the abstract does not name the model", "interval_status": null } ] } } ], "claims": [ { "id": "cardio:claim-aha-acc-2025-replaces-2017", "owner": "cardio", "subject_entity_id": "cardio:pub-aha-acc-2025-hbp", "context_id": "cardio:ctx-aha-acc-2025-adults", "category": "descriptive", "statement": "The abstract of the 2025 AHA/ACC guideline on high blood pressure in adults says that it \"retires and replaces\" the 2017 ACC/AHA guideline on the same subject.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "Only the abstract and bibliographic records were read. The full text was not reachable (HTTP 403 at the publisher), so no definition, threshold, target, recommendation, class of recommendation or level of evidence from the guideline is recorded. Three corrections to the Circulation version and two to the JACC version are listed. Their text was not read, so it is not known whether they change anything the abstract says. This claim states the replacement. It does not link to a record of the 2017 guideline.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-40811497-2026-10-11", "locator": "Abstract, AIM", "evidence_role": "supports", "applicability_note": "PubMed abstract of the Circulation version of the 2025 guideline." }, { "snapshot_id": "cardio:pubmed-40811497-2026-10-11", "locator": "Abstract, METHODS and STRUCTURE", "evidence_role": "context", "applicability_note": "How the evidence was searched, and whom the guideline is for." }, { "snapshot_id": "cardio:pubmed-40811497-2026-10-11", "locator": "CommentsCorrectionsList, three ErratumIn entries", "evidence_role": "context", "applicability_note": "Shows that corrections exist. What they change is unknown." }, { "snapshot_id": "cardio:crossref-jacc-2025-05-007-2026-10-11", "locator": "message.updated-by, two entries", "evidence_role": "context", "applicability_note": "Crossref lists two corrections to the JACC co-publication. What they change is unknown." } ] }, { "id": "cardio:claim-bplttc-mace-per-5mmhg", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-bplttc-trial-participants", "category": "effect", "statement": "In a pooled analysis of individual-participant data from 48 randomised trials of blood-pressure-lowering medicines (344,716 people, median follow-up 4.15 years), a 5 mm Hg lower systolic blood pressure from treatment was associated with a lower risk of a major cardiovascular event: a stroke, a heart attack or ischaemic heart disease, or heart failure that caused death or needed hospital admission. The hazard ratio was 0.91 (95% CI 0.89 to 0.94) in people without previous cardiovascular disease and 0.89 (95% CI 0.86 to 0.92) in people with it. The authors report no reliable evidence that this proportional effect differed between the two groups.", "evidence_stage": "synthesis", "certainty": "not_assessed", "certainty_method": null, "limitations": "The pooled trials differ in design: placebo-controlled trials, comparisons of drug classes, and more-versus-less-intensive treatment. The hazard ratios are standardised to a 5 mm Hg systolic reduction, while the trials' average reduction between their groups, excluding the first 12 months, was 6.3 mm Hg. Previous cardiovascular disease means stroke, myocardial infarction or ischaemic heart disease before randomisation. Trials only in heart failure or acute settings, and people with known heart failure at baseline, are left out. The trials tested blood-pressure-lowering medicines in general, so the result is not specific to the first-line classes named in the WHO recommendations. The estimate is an average across trials. It says nothing about one drug or about benefit for one person. Each component outcome, stroke alone included, is shown in Figure 3 of the paper, an image that could not be read, so no component result is recorded here. The paper's Discussion also states a percentage reduction for each component, which comes from the same component results as Figure 3; those percentages are left unrecorded too, so this claim stays about the combined outcome. A two-stage sensitivity analysis gave similar estimates (0.89 with and 0.92 without previous cardiovascular disease). One erratum only updates the collaboration group list. The numbers are the authors' reported results, taken from the open-access PMC version rather than the publisher's version of record, and nobody has re-analysed them.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Summary (abstract), Findings: participants and trials", "evidence_role": "supports", "applicability_note": "PMC open-access version of the paper; the total number of people and trials in the analysis." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Summary (abstract), Findings: hazard ratios per 5 mm Hg systolic reduction", "evidence_role": "supports", "applicability_note": "The two hazard ratios, by previous cardiovascular disease status." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Results, para 2", "evidence_role": "supports", "applicability_note": "Median follow-up and the number of people with a major cardiovascular event." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Summary (abstract), Findings: heterogeneity sentence", "evidence_role": "supports", "applicability_note": "The authors' statement that treatment effects did not differ reliably by previous cardiovascular disease status." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Methods, Definition of outcomes and comparison groups, para 1", "evidence_role": "context", "applicability_note": "Defines the primary outcome, a major cardiovascular event." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Summary (abstract), Methods, sentences 1 and 2", "evidence_role": "context", "applicability_note": "Which trials were included and which were excluded." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Methods, Study selection criteria, para 1", "evidence_role": "context", "applicability_note": "How previous cardiovascular disease was defined, and the exclusion of people with known heart failure at baseline." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Methods, Statistical analysis, para 1", "evidence_role": "context", "applicability_note": "The average systolic reduction between randomised groups, against which the 5 mm Hg standardisation is set." }, { "snapshot_id": "cardio:pmc-pmc8102467-2026-10-11", "locator": "Results, para 10, two-stage sensitivity analysis", "evidence_role": "context", "applicability_note": "A second method gave similar estimates." }, { "snapshot_id": "cardio:pmc-pmc8165755-2026-10-11", "locator": "Erratum text (Department of Error)", "evidence_role": "context", "applicability_note": "The only erratum updates the collaboration group list and changes no result." } ] }, { "id": "cardio:claim-esc-2024-elevated-bp-category", "owner": "cardio", "subject_entity_id": "core:blood-pressure", "context_id": "cardio:ctx-esc-2024-adults", "category": "descriptive", "statement": "The European Society of Cardiology's summary of its 2024 guideline introduces a blood pressure category called elevated blood pressure: an office systolic pressure of 120 to 139 mmHg or a diastolic pressure of 70 to 89 mmHg. Hypertension remains an office pressure of 140/90 mmHg or higher. The reason the summary gives is that drugs that lower blood pressure can cut cardiovascular risk even for people who fall short of the usual definition of hypertension.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The source is the ESC's own condensed Essential Messages and its guideline page, not the guideline itself, so the table wording, class of recommendation and level of evidence were not read. Two later corrections are listed in PubMed, their text was not read, and the Essential Messages was produced before both, so whether the corrections change the category and thresholds given here is unknown. These are the ESC's office-measurement categories; home and ambulatory thresholds were not read. Any other guideline states its own categories and thresholds. A claim about another guideline is recorded separately and is not reconciled with this one, so this claim does not say which is right or that the categories are interchangeable. Pregnancy handling is not stated in the sources read.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:esc-essential-messages-2026-10-11", "locator": "Section 1 Key messages, message 4", "evidence_role": "supports", "applicability_note": "ESC Essential Messages PDF for the 2024 guideline." }, { "snapshot_id": "cardio:esc-guideline-page-2026-10-11", "locator": "Introduction: new simplified classification of blood pressure", "evidence_role": "context", "applicability_note": "The ESC page confirms a new classification without giving values." }, { "snapshot_id": "cardio:esc-guideline-page-2026-10-11", "locator": "Corrigendum link", "evidence_role": "context", "applicability_note": "The ESC page links a corrigendum dated 11 February 2025; its text was not read." }, { "snapshot_id": "cardio:pubmed-39210715-2026-10-11", "locator": "CommentsCorrectionsList, two ErratumIn entries", "evidence_role": "context", "applicability_note": "Shows that two corrections exist. What they change is unknown." } ] }, { "id": "cardio:claim-esc-2024-on-treatment-target", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-to-target", "context_id": "cardio:ctx-esc-2024-adults", "category": "recommendation", "statement": "The European Society of Cardiology's summary of its 2024 guideline gives 120 to 129 mmHg systolic and 70 to 79 mmHg diastolic as the pressure to aim for during treatment in all adults, if the treatment is well tolerated. It says the aim is the same whatever the pressure at which treatment is advised to start. It also says there are a number of important exceptions, and that decisions made for the individual patient always come first.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The source is the ESC's condensed Essential Messages, not the recommendation tables, so the class of recommendation, the level of evidence, the exceptions and the pressure at which to start treatment were not read. This is a claim only and has no recommendation decision. Two later corrections are listed in PubMed, their text was not read, and the Essential Messages was produced before both, so whether the corrections change the target given here is unknown. Any other guideline states its own target. A claim about another guideline is recorded separately and is not reconciled with this one, so this claim does not say which target is right. Pregnancy handling is not stated in the sources read.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:esc-essential-messages-2026-10-11", "locator": "Section 1 Key messages, message 10", "evidence_role": "supports", "applicability_note": "ESC Essential Messages PDF for the 2024 guideline." }, { "snapshot_id": "cardio:esc-essential-messages-2026-10-11", "locator": "Back page, corrections notice", "evidence_role": "context", "applicability_note": "The ESC says it posts corrections and updates made after publication on its guidelines page." }, { "snapshot_id": "cardio:pubmed-39210715-2026-10-11", "locator": "CommentsCorrectionsList, two ErratumIn entries", "evidence_role": "context", "applicability_note": "Shows that two corrections exist. What they change is unknown." } ] }, { "id": "cardio:claim-esh-cuffless-not-recommended", "owner": "cardio", "subject_entity_id": "cardio:idea-cuffless-bp-monitoring", "context_id": "cardio:ctx-esh-cuffless-population-unstated", "category": "descriptive", "statement": "A 2022 statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability says that \"recent guidelines by the European Society of Hypertension do not recommend cuffless devices for the diagnosis and management of hypertension\". It says the established validation protocols for cuff devices are inadequate for cuffless ones. It also says cuffless devices have \"considerable potential for changing the diagnosis and management of hypertension\", but that \"fundamental questions regarding their accuracy, performance, and implementation need to be carefully addressed before they can be recommended for clinical use\".", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "Abstract only: the full text was not fetched. The abstract names no patient population, so the population is not stated here. The abstract attributes the do-not-recommend position to recent guidelines and does not name the edition. This is a working group statement that reports that position. It is not a guideline recommendation row, and it was published in 2022. Newer cuffless devices and studies since then were not checked. A statement that devices are not recommended is not a finding that any particular device is inaccurate.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, sentence 3", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2022 statement." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, sentence 6", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2022 statement." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, second-to-last sentence", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2022 statement." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, last sentence", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2022 statement." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, sentence 1", "evidence_role": "context", "applicability_note": "Says many such devices are on the market and claim to be accurate." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, sentence 2", "evidence_role": "context", "applicability_note": "States the potential the working group sees." }, { "snapshot_id": "cardio:pubmed-35708294-2026-10-11", "locator": "Abstract, sentence 5", "evidence_role": "context", "applicability_note": "Says cuffless devices are a heterogeneous group with different intended uses." } ] }, { "id": "cardio:claim-esh-cuffless-six-validation-tests", "owner": "cardio", "subject_entity_id": "cardio:idea-cuffless-bp-monitoring", "context_id": "cardio:ctx-esh-cuffless-population-unstated", "category": "descriptive", "statement": "A 2023 statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability recommends six validation tests for intermittent cuffless blood pressure devices, which take readings at intervals longer than 30 seconds, usually every 30 to 60 minutes, or when the user starts a reading. The tests are static, device position, treatment, awake and asleep, exercise and recalibration. Not every test is required for every device. The statement says that, to date, there were no generally accepted validation protocols for these devices.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "Abstract only: the full text was not fetched, so the pass criteria, sample sizes and which test applies to which device are not described here. The abstract names no patient population, so the population is not stated here. It covers intermittent cuffless devices only. The statement proposes how to validate devices. It is not a finding that any device has passed. Work after December 2023 was not checked.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 5, first part", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2023 statement." }, { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 5, second part", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2023 statement. First three tests." }, { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 5, last part", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2023 statement. Last three tests." }, { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 6", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2023 statement." }, { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 3", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2023 statement." }, { "snapshot_id": "cardio:pubmed-37303198-2026-10-11", "locator": "Abstract, sentence 4, definition of intermittent", "evidence_role": "context", "applicability_note": "Defines which cuffless devices the tests are for." } ] }, { "id": "cardio:claim-fda-k001848-clearance", "owner": "cardio", "subject_entity_id": "cardio:omron-hem-907", "context_id": "cardio:ctx-fda-k001848-us-clearance", "category": "regulatory", "statement": "The US Food and Drug Administration cleared the Omron IntelliSense blood pressure monitor, model HEM-907, under 510(k) number K001848 on 3 July 2000. The FDA record gives the decision as Substantially Equivalent and the clearance type as Special. It lists the product code DXN, device class 2 and regulation number 870.1130, and names Omron Healthcare, Inc. as the applicant.", "evidence_stage": "not_applicable", "certainty": "not_assessed", "certainty_method": null, "limitations": "The FDA record is a Statement, not a Summary, and no indications-for-use text was found, so the intended population and use are not stated here. The 510(k) PDF address returned HTTP 404 when fetched on 2026-10-11 (label ca-fda-k001848-pdf.html). This claim records the decision and the fields the FDA record gives. A clearance is not a finding about how accurate the monitor is for any person or in everyday use. It applies to the HEM-907 only: FDA lists the HEM-907XL as a separate model under a different number. openFDA's own disclaimer says \"Do not rely on openFDA to make decisions regarding medical care\".", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].k_number", "evidence_role": "supports", "applicability_note": "The 510(k) number of this record." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].device_name", "evidence_role": "supports", "applicability_note": "Names the model as HEM-907." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].applicant", "evidence_role": "supports", "applicability_note": "The applicant, as FDA writes the name." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].decision_date", "evidence_role": "supports", "applicability_note": "ISO date. The FDA database page writes the same date as a month-first slash date." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].decision_description", "evidence_role": "supports", "applicability_note": "The decision wording used for a 510(k) clearance." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].clearance_type", "evidence_role": "supports", "applicability_note": "The clearance type as FDA records it. This atlas does not explain what the type means." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].product_code", "evidence_role": "supports", "applicability_note": "FDA product code of this record." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].openfda.device_class", "evidence_role": "supports", "applicability_note": "Device class as the openFDA block writes it." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].openfda.regulation_number", "evidence_role": "supports", "applicability_note": "The top-level regulation_number field is empty in this record. The openFDA block gives 870.1130." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].openfda.device_name", "evidence_role": "context", "applicability_note": "FDA's name for the device type, which is broader than one model." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "results[0].statement_or_summary", "evidence_role": "context", "applicability_note": "Shows the record is a Statement, which is why no indications text was found." }, { "snapshot_id": "cardio:openfda-510k-k001848-2026-10-11", "locator": "meta.disclaimer", "evidence_role": "context", "applicability_note": "openFDA's own disclaimer about relying on its data." } ] }, { "id": "cardio:claim-hem907-passed-international-protocol", "owner": "cardio", "subject_entity_id": "cardio:omron-hem-907", "context_id": "cardio:ctx-hem907-validation-2002", "category": "descriptive", "statement": "A 2002 paper in Blood Pressure Monitoring reports that the Omron HEM-907 passed both phases of the international validation protocol. The final phase used 33 people in all. Two trained observers took readings with mercury sphygmomanometers, alternating with the device, and 99 measurements were compared. In the second phase the average differences between the device and the mercury readings were -1 +/- 7 mmHg for systolic and -5 +/- 6 mmHg for diastolic pressure.", "evidence_stage": "observational", "certainty": "not_assessed", "certainty_method": null, "limitations": "Abstract only: the full text was not fetched. The abstract calls the test the international validation protocol and does not name who wrote it, so it is not called the ESH International Protocol here. A pass in 33 people measured in a study session is not accuracy in everyday use, at home or in a clinic. The abstract does not describe who the 33 people were. It tested the HEM-907 only, and the result does not carry over to the HEM-907XL or to any other model. The protocol itself was not read, so the pass criteria are not described here.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, sentence 2", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2002 paper." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, sentence 3", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2002 paper." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, sentence 4", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2002 paper." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, sentence 8, opening words", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2002 paper. Opening words of the second-phase sentence." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, sentence 8", "evidence_role": "supports", "applicability_note": "PubMed abstract of the 2002 paper." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Abstract, last sentence", "evidence_role": "supports", "applicability_note": "The authors' own conclusion in the abstract." }, { "snapshot_id": "cardio:pubmed-12198340-2026-10-11", "locator": "Article title", "evidence_role": "context", "applicability_note": "Names the device as the Omron HEM-907." }, { "snapshot_id": "cardio:stridebp-device-hem907-2026-10-12", "locator": "Device page for the Omron HEM-907", "evidence_role": "context", "applicability_note": "An outside group that keeps its own device lists has a page for this model. It is named and linked for identity only, and its content is not restated here." } ] }, { "id": "cardio:claim-high-sodium-raises-stroke-risk", "owner": "cardio", "subject_entity_id": "cardio:high-sodium-intake", "context_id": "cardio:ctx-who-adults-sodium-intake", "category": "descriptive", "statement": "The WHO 2012 sodium guideline reports that, in cohort studies of adults, people who ate more sodium had more strokes than people who ate the least. The pooled risk ratio was 1.24 (95% CI 1.08 to 1.43) for stroke and 1.63 (95% CI 1.27 to 2.10) for fatal stroke. WHO rated the evidence very low quality for stroke and low quality for fatal stroke. These are observational comparisons of higher and lower intake groups.", "evidence_stage": "synthesis", "certainty": "very_low", "certainty_method": "WHO's own GRADE quality ratings, printed in the 2012 guideline: very low for the stroke result and low for the fatal stroke result. The claim takes the lower rating.", "limitations": "Observational cohort data with very low to low quality ratings from WHO. Groups were compared on sodium intake, not on a change in intake, and the guideline notes that some cohort studies found no link, an inverse link (higher intake with lower risk) or a J-shaped curve. Intake ranges differed widely between studies, and the lowest-intake groups in some studies ate as much as 4 g of sodium a day, so the comparison is not intake above against below the WHO limit of 2 g. Nothing here shows that cutting sodium prevents strokes; the SSaSS claim concerns a different intervention.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Executive summary, Background, paragraph 1", "evidence_role": "supports", "applicability_note": "WHO links high sodium intake with hypertension, cardiovascular disease and stroke." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Summary of evidence, page 13, meta-analysis of cohort studies", "evidence_role": "supports", "applicability_note": "Pooled risk ratio for stroke, quality very low." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Summary of evidence, page 13, fatal stroke", "evidence_role": "supports", "applicability_note": "Pooled risk ratio for fatal stroke, quality low." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Summary of evidence, page 13, cohort studies and comparison groups", "evidence_role": "context", "applicability_note": "Fifteen cohort studies in adults, reference group lowest intake, comparison group generally highest." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Background, page 6", "evidence_role": "context", "applicability_note": "Most cohort studies reported a direct relationship, but not all." } ] }, { "id": "cardio:claim-hypertension-raises-stroke-risk", "owner": "cardio", "subject_entity_id": "core:hypertension", "context_id": "cardio:ctx-who-2012-general-statement", "category": "descriptive", "statement": "The WHO 2012 sodium guideline calls hypertension a major risk factor for cardiovascular disease, in particular for heart attack and stroke. It also says the link between higher blood pressure and higher risk of cardiovascular disease, coronary heart disease and stroke most of all, is well established.", "evidence_stage": "unknown", "certainty": "not_assessed", "certainty_method": null, "limitations": "A background statement in a guideline about sodium; the fetched text gives no study data for it and does not say how much hypertension raises stroke risk. The second statement concerns blood pressure as a continuous measure, not the diagnosis of hypertension. It does not say that lowering blood pressure prevents stroke.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Background, page 5", "evidence_role": "supports", "applicability_note": "Calls hypertension a major risk factor, in particular for heart attack and stroke." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Summary of evidence, page 13", "evidence_role": "supports", "applicability_note": "Well-established relationship between blood pressure and risk of stroke." } ] }, { "id": "cardio:claim-nice-ng136-1-1-3-validated-devices", "owner": "cardio", "subject_entity_id": "core:automated-upper-arm-cuff-device", "context_id": "cardio:ctx-nice-ng136-adults-measuring-bp", "category": "recommendation", "statement": "NICE guideline NG136, recommendation 1.1.3, tagged with the year 2004, puts a duty on healthcare providers: every blood pressure device they use must be properly validated, kept in working order and recalibrated on a regular schedule as its manufacturer directs. It also refers readers to the website of the British and Irish Hypertension Society, which holds a list of validated blood pressure monitors.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The recommendation is about devices for measuring blood pressure in general. The fetched page does not name automated upper-arm cuff devices in it, so this claim is placed on the technology page as the nearest guideline statement and does not say that NICE recommends the technology. The page does not define properly validated. The British and Irish Hypertension Society list itself was not opened. Its guidance page, at the address NICE links to, loads (fetch label ca-bihs-nice-link.html). Its list is a linked spreadsheet. The other address tried first, bihsoc.org, failed the certificate check (fetch label ca-bihs-bp-monitors.html). The recommendation is tagged with the year 2004 and no later edition of this recommendation was checked. The strength of the word must was not verified, and this atlas states NICE's recommendations in its own words because of NICE's reuse terms (see the NICE NG136 source record). The jurisdiction is not stated on the fetched page.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.1.3, sentence 1", "evidence_role": "supports", "applicability_note": "NICE NG136 as shown on 2026-10-09 and again on 2026-10-11 (same bytes), last updated 2026-02-26." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.1.3, sentence 2", "evidence_role": "supports", "applicability_note": "The list the recommendation points to." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.1.3, version tag", "evidence_role": "context", "applicability_note": "Dates the wording of this recommendation." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Introduction to Recommendations, scope paragraph", "evidence_role": "context", "applicability_note": "Says the measurement and diagnosis recommendations cover every adult, people with type 2 diabetes among them." } ] }, { "id": "cardio:claim-nice-ng136-1-2-3", "owner": "cardio", "subject_entity_id": "cardio:ambulatory-bp-monitoring", "context_id": "cardio:ctx-nice-adults-suspected-hypertension", "category": "recommendation", "statement": "NICE guideline NG136 recommends offering ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension in adults whose clinic blood pressure is between 140/90 and 180/120 mmHg.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. A clinic reading of 180/120 mmHg or higher is handled in a separate NICE referral section. This claim records what NICE recommends. It does not say that ABPM is the only or best way to confirm the diagnosis.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.3", "evidence_role": "supports", "applicability_note": "NICE NG136 as shown on 2026-10-11, last updated 2026-02-26. Offer ABPM to confirm the diagnosis." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.3, version tag at the end", "evidence_role": "context", "applicability_note": "Dates the wording of the recommendation." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendations, introductory text, paragraph 3", "evidence_role": "context", "applicability_note": "Says the measuring and diagnosing recommendations apply to all adults." }, { "snapshot_id": "cardio:nice-making-decisions-2026-10-09", "locator": "Using recommendations, paragraph 2", "evidence_role": "context", "applicability_note": "Explains the NICE convention for the word offer. It does not say how the convention applies to this recommendation." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 6, sentence 1", "evidence_role": "context", "applicability_note": "Source of the England audience read for this claim." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 8", "evidence_role": "context", "applicability_note": "Source of the United Kingdom reliance limit read for this claim." } ] }, { "id": "cardio:claim-nice-ng136-1-2-4", "owner": "cardio", "subject_entity_id": "core:home-bp-monitoring", "context_id": "cardio:ctx-nice-adults-suspected-hypertension", "category": "recommendation", "statement": "NICE guideline NG136 recommends offering home blood pressure monitoring (HBPM) to confirm a diagnosis of hypertension in adults when ABPM is not suitable or not tolerated.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. NICE places this recommendation second, after ABPM. This claim records what NICE recommends. It does not say how well home monitoring performs, and it covers no pregnancy use.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.4", "evidence_role": "supports", "applicability_note": "NICE NG136 as shown on 2026-10-11, last updated 2026-02-26. Offer HBPM when ABPM is unsuitable or not tolerated." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.4, version tag at the end", "evidence_role": "context", "applicability_note": "Dates the wording of the recommendation." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendations, introductory text, paragraph 3", "evidence_role": "context", "applicability_note": "Says the measuring and diagnosing recommendations apply to all adults." }, { "snapshot_id": "cardio:nice-making-decisions-2026-10-09", "locator": "Using recommendations, paragraph 2", "evidence_role": "context", "applicability_note": "Explains the NICE convention for the word offer. It does not say how the convention applies to this recommendation." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 6, sentence 1", "evidence_role": "context", "applicability_note": "Source of the England audience read for this claim." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 8", "evidence_role": "context", "applicability_note": "Source of the United Kingdom reliance limit read for this claim." } ] }, { "id": "cardio:claim-nice-ng136-1-2-8-thresholds", "owner": "cardio", "subject_entity_id": "core:blood-pressure", "context_id": "cardio:ctx-nice-adults-suspected-hypertension", "category": "descriptive", "statement": "NICE guideline NG136 confirms a diagnosis of hypertension in adults whose clinic blood pressure is 140/90 mmHg or higher and whose ambulatory daytime average or home average is 135/85 mmHg or higher.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "This states the confirmation rule of one guideline edition. It is not the atlas definition of hypertension, and it says nothing about when to start treatment. NICE gives no strength label for this recommendation, and its wording is a rule rather than an offer or a suggestion. The recommendation carries the year tag 2019. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. Other guidelines set other thresholds, which are recorded in their own claims.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.8, first part", "evidence_role": "supports", "applicability_note": "The clinic reading condition." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.2.8, second part and version tag", "evidence_role": "supports", "applicability_note": "The ambulatory daytime and home averages, and the version tag." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendations, introductory text, paragraph 3", "evidence_role": "context", "applicability_note": "Says the diagnosing recommendations apply to all adults." }, { "snapshot_id": "cardio:nice-ng136-update-information-2026-10-11", "locator": "Update information, August 2019 entry", "evidence_role": "context", "applicability_note": "Explains that recommendations marked with the 2019 tag were made after a 2019 evidence review." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 6, sentence 1", "evidence_role": "context", "applicability_note": "Source of the England audience read for this claim." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 8", "evidence_role": "context", "applicability_note": "Source of the United Kingdom reliance limit read for this claim." } ] }, { "id": "cardio:claim-nice-ng136-1-4-5-salt-caution", "owner": "cardio", "subject_entity_id": "cardio:salt-substitution", "context_id": "cardio:ctx-nice-ng136-adults-hypertension-potassium-substitute-groups", "category": "recommendation", "statement": "NICE guideline NG136 advises encouraging people to keep their sodium intake low, either by cutting back on salt or by using a salt substitute in its place. It adds that older people, people with diabetes, people with kidney disease, and people on some blood-pressure medicines (for example ACE inhibitors and angiotensin II receptor blockers) should not use salt substitutes that contain potassium chloride, and says these groups should be encouraged to cut down on salt instead. The recommendation is tagged as dating from 2004 and amended in 2019, so it predates the SSaSS report and the WHO salt-substitute guideline, which are recorded separately. NICE also names pregnant women in this list; that group is outside this claim context and belongs to the maternal atlas.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The fetched page gives no reasoning for the caution, and the NICE rationale was not read. It says people, and sits in the lifestyle section whose first recommendation is addressed to people who may have hypertension or have been diagnosed with it. Older people has no age bound. What the 2019 amendment changed was not checked. The wording is imperative with no NICE strength label, and its meaning was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The page shows a last update of 26 February 2026. NICE's reuse terms limit outside use of its wording, so this atlas states the caution in its own words. This caution and the WHO suggestion are shown side by side; neither is shown to be right.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.5, sentence 2", "evidence_role": "supports", "applicability_note": "The caution on potassium chloride salt substitutes and the groups it names." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.5, sentence 1", "evidence_role": "supports", "applicability_note": "The advice to keep sodium low by reducing or substituting salt." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.5, sentence 3 and tag", "evidence_role": "supports", "applicability_note": "Advice to reduce salt in these groups, with the 2004 and 2019 tag." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.1 and section 1.4 heading", "evidence_role": "context", "applicability_note": "The section the recommendation sits in addresses people with suspected or diagnosed hypertension." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Page header, Published and Last updated", "evidence_role": "context", "applicability_note": "Guideline first published 28 August 2019, last updated 26 February 2026." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 6, sentence 1", "evidence_role": "context", "applicability_note": "Source of the England audience read for this claim." }, { "snapshot_id": "cardio:nice-terms-and-conditions-2026-10-11", "locator": "Clause 8", "evidence_role": "context", "applicability_note": "Source of the United Kingdom reliance limit read for this claim." } ] }, { "id": "cardio:claim-nice-ng136-target-under-80", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-to-target", "context_id": "cardio:ctx-nice-adults-under-80-hypertension", "category": "recommendation", "statement": "NICE guideline NG136 recommends lowering clinic blood pressure below 140/90 mmHg, and keeping it there, for adults with hypertension aged under 80.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "NICE's population includes people with type 2 diabetes, whom SPRINT excluded. The fetched page gives no strength label for this imperative wording (a pair of directive verbs, one to lower the pressure and one to keep it there), and NICE's page on recommendation wording explains only the verbs offer and consider. The jurisdiction is not stated on the fetched page. The recommendation carries the tag 2019, amended 2022; the exact amendment date was not recorded. This claim records what NICE recommends. It does not say that NICE assessed or rejected SPRINT's target.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.20, the sentence on adults aged under 80", "evidence_role": "supports", "applicability_note": "NICE NG136 as shown on 2026-10-09, last updated 2026-02-26." }, { "snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "locator": "Recommendation 1.4.20, version tag", "evidence_role": "context", "applicability_note": "Dates the wording of this recommendation." }, { "snapshot_id": "cardio:nice-making-decisions-2026-10-09", "locator": "Section on recommendation wording, the sentence on the verb offer", "evidence_role": "context", "applicability_note": "Explains how NICE uses the verb offer. It does not say what strength imperative verbs such as reduce carry." } ] }, { "id": "cardio:claim-sprint-mortality-effect", "owner": "cardio", "subject_entity_id": "cardio:intensive-sbp-lowering", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "category": "effect", "statement": "In the same trial and time window, fewer people in the lower-target group died from any cause: 155 of 4678 versus 210 of 4683 (hazard ratio 0.73, 95% CI 0.60 to 0.90).", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Secondary outcome. The limits of the primary-effect claim also apply: one open-label trial stopped early for benefit, results the authors do not extend to people with diabetes, prior stroke or age under 50, or to nursing-home residents, and a 2017 erratum whose content was not verified.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "locator": "Abstract, RESULTS, sentence 3: \"All-cause mortality was also significantly lower in the intensive-treatment group (hazard ratio, 0.73; 95% CI, 0.60 to 0.90; P=0.003).\"", "evidence_role": "supports", "applicability_note": "Abstract of the primary report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Results, Clinical outcomes, para 2: \"155 in the intensive-treatment group and 210 in the standard-treatment group\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Table 2, \"All participants\" header row: \"All participants (N = 4678) (N = 4683)\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Discussion, para 7: \"persons with diabetes, those with prior stroke, and those younger than 50 years of age\"", "evidence_role": "context", "applicability_note": "The groups to whom the authors say the results do not generalize." }, { "snapshot_id": "cardio:pubmed-29262284-2026-10-09", "locator": "PubMed record of the 2017 erratum (PMID 29262284); the record has no text", "evidence_role": "context", "applicability_note": "Shows that a correction exists. What it changes, and whether it affects these numbers, is unknown." } ] }, { "id": "cardio:claim-sprint-primary-effect", "owner": "cardio", "subject_entity_id": "cardio:intensive-sbp-lowering", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "category": "effect", "statement": "In SPRINT, adults aged 50 and over at raised heart risk, without diabetes or a past stroke, whose treatment aimed for a top (systolic) blood pressure below 120 mm Hg had fewer major heart and blood-vessel events than those aiming for below 140. Over a median of 3.26 years, 243 of 4678 people in the lower-target group and 319 of 4683 in the standard group had a first primary-outcome event (hazard ratio 0.75, 95% CI 0.64 to 0.89).", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "One open-label trial; outcome adjudicators did not know the assignment. The blood-pressure intervention was stopped early for benefit after crossing a monitoring boundary. The authors say the results do not generalize to people with diabetes, prior stroke or age under 50, or to nursing-home residents. The paper and the registry word the older-age entry criterion differently (\"75 years or older\" versus \"greater than 75 years\"), and this is not reconciled. The publication has a 2017 erratum whose content was not verified. Full-text figures come from the PMC author manuscript.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "locator": "Abstract, RESULTS, sentence 2: \"hazard ratio with intensive treatment, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P<0.001\"", "evidence_role": "supports", "applicability_note": "Abstract of the primary report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Results, Clinical outcomes, para 1: \"243 (1.65% per year) in the intensive-treatment group and 319 (2.19% per year) in the standard-treatment group\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Table 2, \"All participants\" header row: \"All participants (N = 4678) (N = 4683)\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:ctgov-nct01206062-2026-10-09", "locator": "resultsSection, primary outcome measure (posted results 243 of 4678 and 319 of 4683; HR 0.75, 0.64 to 0.89)", "evidence_role": "supports", "applicability_note": "The registry posted results equal the paper's figures." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Methods, Study population, para 1: \"or an age of 75 years or older\"", "evidence_role": "context", "applicability_note": "Paper wording of the older-age criterion." }, { "snapshot_id": "cardio:ctgov-nct01206062-2026-10-09", "locator": "eligibilityModule.eligibilityCriteria: \"Age greater than 75 years\"", "evidence_role": "context", "applicability_note": "Registry wording of the older-age criterion differs from the paper and is not reconciled." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Discussion, para 7: \"persons with diabetes, those with prior stroke, and those younger than 50 years of age\"", "evidence_role": "context", "applicability_note": "The groups to whom the authors say the results do not generalize." }, { "snapshot_id": "cardio:pubmed-29262284-2026-10-09", "locator": "PubMed record of the 2017 erratum (PMID 29262284); the record has no text", "evidence_role": "context", "applicability_note": "Shows that a correction exists. What it changes, and whether it affects these numbers, is unknown." } ] }, { "id": "cardio:claim-sprint-safety", "owner": "cardio", "subject_entity_id": "cardio:intensive-sbp-lowering", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "category": "safety", "statement": "Some serious side effects were more common with the lower target: serious adverse events of low blood pressure, fainting, abnormal blood salt levels (electrolytes), and sudden kidney injury or failure. Serious falls causing injury were not more common.", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Event counts and rates are in Table 3 and supplementary tables of the paper, which were not extracted. In an open-label trial, participants and study staff knew the assignment when adverse events were recorded. The 2017 erratum content was not verified.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "locator": "Abstract, RESULTS, sentence 4: \"Rates of serious adverse events of hypotension, syncope, electrolyte abnormalities, and acute kidney injury or failure, but not of injurious falls, were higher\"", "evidence_role": "supports", "applicability_note": "Abstract of the primary report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Methods, Randomization and interventions, para 1: \"Participants and study personnel were aware of the study-group assignments, but outcome adjudicators were not.\"", "evidence_role": "context", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:pubmed-29262284-2026-10-09", "locator": "PubMed record of the 2017 erratum (PMID 29262284); the record has no text", "evidence_role": "context", "applicability_note": "Shows that a correction exists. What it changes, and whether it affects these numbers, is unknown." } ] }, { "id": "cardio:claim-sprint-stopped-early", "owner": "cardio", "subject_entity_id": "cardio:sprint", "context_id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "category": "descriptive", "statement": "SPRINT's blood-pressure intervention was stopped early. On 20 August 2015 the NHLBI director accepted the data and safety monitoring board's recommendation, after analyses of the primary outcome crossed the monitoring boundary at two time points in a row. Median follow-up by then was 3.26 years, against a planned average of 5 years.", "evidence_stage": "not_applicable", "certainty": "not_assessed", "certainty_method": null, "limitations": "The registry gives a planned maximum follow-up of 6 years, while the paper gives a planned average of 5 years. These are different measures and are not reconciled.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-26551272-2026-10-09", "locator": "Abstract, RESULTS, sentence 2: \"The intervention was stopped early after a median follow-up of 3.26 years owing to a significantly lower rate of the primary composite outcome\"", "evidence_role": "supports", "applicability_note": "Abstract of the primary report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Results, Study participants, para 1: \"On August 20, 2015, the NHLBI director accepted a recommendation from the data and safety monitoring board\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." }, { "snapshot_id": "cardio:pmc-pmc4689591-2026-10-09", "locator": "Results, Study participants, para 1: \"after analyses of the primary outcome exceeded the monitoring boundary at two consecutive time points\"", "evidence_role": "supports", "applicability_note": "PMC author manuscript, not the version of record." } ] }, { "id": "cardio:claim-ssass-hyperkalemia-safety", "owner": "cardio", "subject_entity_id": "cardio:salt-substitution", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "category": "safety", "statement": "In SSaSS, serious adverse events attributed to hyperkalemia (too much potassium in the blood) were not significantly more frequent with the salt substitute: 3.35 events per 1000 person-years against 3.30 with regular salt (rate ratio 1.04, 95% CI 0.80 to 1.37). Not significantly higher is not the same as no difference or no risk.", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "The abstract names clinical hyperkalemia as the safety outcome and reports serious adverse events attributed to it. The registry excluded households using potassium-sparing diuretics or potassium supplements and people with serious renal impairment, so the result does not speak to those groups. WHO notes that all trials in its review excluded people who might be harmed by extra potassium. One open-label, cluster-randomized trial in rural China. The result applies to people who had had a stroke or were 60 or over with high blood pressure and met the other entry rules, such as no potassium-sparing diuretic, potassium supplement or serious kidney impairment in the household. It does not show the same effect in other groups or places. The tested package is ongoing dietary advice plus the substitute, compared with dietary advice at baseline only (registry). The abstract calls the trial open-label, while the registry records masking as DOUBLE (investigator and outcomes assessor); the two are not reconciled. The registry counts 20996 participants and the abstract 20,995; the reason is unknown. Only the abstract and the registry were read: the NEJM full text returned HTTP 403 and no open copy exists, so event counts, person-years, per-arm intervals and any correction are not recorded.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, RESULTS, sentence 5", "evidence_role": "supports", "applicability_note": "Abstract of the main report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, METHODS, sentence 4", "evidence_role": "context", "applicability_note": "Names clinical hyperkalemia as the safety outcome." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.eligibilityModule.eligibilityCriteria, exclusion", "evidence_role": "context", "applicability_note": "Registry exclusions on potassium-sparing diuretics, potassium supplements and serious renal impairment." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, The evidence, page viii", "evidence_role": "context", "applicability_note": "WHO says all trials in its review excluded people who could be harmed by extra potassium." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, METHODS, sentences 1 to 3", "evidence_role": "context", "applicability_note": "Design, population, villages and what each arm used." } ] }, { "id": "cardio:claim-ssass-mortality-effect", "owner": "cardio", "subject_entity_id": "cardio:salt-substitution", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "category": "effect", "statement": "In the same trial and time window, deaths from any cause were less frequent with the salt substitute: 39.28 events per 1000 person-years against 44.61 with regular salt (rate ratio 0.88, 95% CI 0.82 to 0.95). Death from any cause was a secondary outcome.", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Secondary outcome. The limits of the stroke claim apply: One open-label, cluster-randomized trial in rural China. The result applies to people who had had a stroke or were 60 or over with high blood pressure and met the other entry rules, such as no potassium-sparing diuretic, potassium supplement or serious kidney impairment in the household. It does not show the same effect in other groups or places. The tested package is ongoing dietary advice plus the substitute, compared with dietary advice at baseline only (registry). The abstract calls the trial open-label, while the registry records masking as DOUBLE (investigator and outcomes assessor); the two are not reconciled. The registry counts 20996 participants and the abstract 20,995; the reason is unknown. Only the abstract and the registry were read: the NEJM full text returned HTTP 403 and no open copy exists, so event counts, person-years, per-arm intervals and any correction are not recorded.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, RESULTS, sentence 4 (death)", "evidence_role": "supports", "applicability_note": "Abstract of the main report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, RESULTS, sentence 3", "evidence_role": "supports", "applicability_note": "Mean follow-up stated in the abstract." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, METHODS, sentences 1 to 3", "evidence_role": "context", "applicability_note": "Design, population, villages and what each arm used." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.armsInterventionsModule.armGroups and interventions[0].description", "evidence_role": "context", "applicability_note": "Registry description of the two arms: ongoing advice plus the substitute, versus advice at baseline only." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.designModule.designInfo.maskingInfo", "evidence_role": "context", "applicability_note": "The registry records masking as DOUBLE (investigator and outcomes assessor); the abstract says open-label. Not reconciled." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.designModule.enrollmentInfo.count", "evidence_role": "context", "applicability_note": "Registry enrollment 20996, against 20,995 in the abstract. Not reconciled." } ] }, { "id": "cardio:claim-ssass-stroke-effect", "owner": "cardio", "subject_entity_id": "cardio:salt-substitution", "context_id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "category": "effect", "statement": "In SSaSS, in rural Chinese villages, people who had had a stroke or were 60 or older with high blood pressure had fewer strokes when their village used a lower-sodium, potassium-enriched salt substitute, with ongoing dietary advice, than when it kept using regular salt. Over a mean follow-up of 4.74 years the stroke rate was 29.14 events per 1000 person-years with the substitute and 33.65 with regular salt (rate ratio 0.86, 95% CI 0.77 to 0.96).", "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "One open-label, cluster-randomized trial in rural China. The result applies to people who had had a stroke or were 60 or over with high blood pressure and met the other entry rules, such as no potassium-sparing diuretic, potassium supplement or serious kidney impairment in the household. It does not show the same effect in other groups or places. The tested package is ongoing dietary advice plus the substitute, compared with dietary advice at baseline only (registry). The abstract calls the trial open-label, while the registry records masking as DOUBLE (investigator and outcomes assessor); the two are not reconciled. The registry counts 20996 participants and the abstract 20,995; the reason is unknown. Only the abstract and the registry were read: the NEJM full text returned HTTP 403 and no open copy exists, so event counts, person-years, per-arm intervals and any correction are not recorded.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, RESULTS, sentence 4", "evidence_role": "supports", "applicability_note": "Abstract of the main report, for the same population and follow-up as this context." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, RESULTS, sentence 3", "evidence_role": "supports", "applicability_note": "Mean follow-up stated in the abstract." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, CONCLUSIONS, sentence 1", "evidence_role": "supports", "applicability_note": "The authors conclude for the same population." }, { "snapshot_id": "cardio:pubmed-34459569-2026-10-11", "locator": "Abstract, METHODS, sentences 1 to 3", "evidence_role": "context", "applicability_note": "Design, population, villages and what each arm used." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.armsInterventionsModule.armGroups and interventions[0].description", "evidence_role": "context", "applicability_note": "Registry description of the two arms: ongoing advice plus the substitute, versus advice at baseline only." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.designModule.designInfo.maskingInfo", "evidence_role": "context", "applicability_note": "The registry records masking as DOUBLE (investigator and outcomes assessor); the abstract says open-label. Not reconciled." }, { "snapshot_id": "cardio:ctgov-nct02092090-2026-10-11", "locator": "protocolSection.designModule.enrollmentInfo.count", "evidence_role": "context", "applicability_note": "Registry enrollment 20996, against 20,995 in the abstract. Not reconciled." } ] }, { "id": "cardio:claim-who-2021-r1a", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "category": "recommendation", "statement": "WHO recommends starting blood-pressure-lowering medicine in adults with confirmed hypertension whose systolic pressure is 140 mmHg or higher or whose diastolic pressure is 90 mmHg or higher.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "WHO labels this statement \"Strong recommendation, moderate- to high-certainty evidence\". The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. An implementation remark says treatment should start no later than four weeks after diagnosis. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, first statement (part 1)", "evidence_role": "supports", "applicability_note": "Who and what WHO recommends treating." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, first statement (part 2)", "evidence_role": "supports", "applicability_note": "The blood pressure thresholds." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, first statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Strong recommendation, moderate- to high-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, implementation remarks", "evidence_role": "context", "applicability_note": "WHO implementation remark that applies to recommendation 1." } ] }, { "id": "cardio:claim-who-2021-r1b", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-cvd-sbp-130-139", "category": "recommendation", "statement": "WHO recommends blood-pressure-lowering medicine in adults with existing cardiovascular disease whose systolic pressure is 130 to 139 mmHg.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "WHO labels this statement \"Strong recommendation, moderate- to high-certainty evidence\". The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. This statement sits beside 1a and 1c, which carry other populations and, for 1c, a different strength. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, second statement", "evidence_role": "supports", "applicability_note": "The population and threshold WHO recommends treating." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, second statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Strong recommendation, moderate- to high-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, implementation remarks", "evidence_role": "context", "applicability_note": "WHO implementation remark that applies to recommendation 1." } ] }, { "id": "cardio:claim-who-2021-r1c", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-high-risk-sbp-130-139", "category": "recommendation", "statement": "WHO suggests blood-pressure-lowering medicine in adults without cardiovascular disease who have high cardiovascular risk, diabetes or chronic kidney disease and whose systolic pressure is 130 to 139 mmHg.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "WHO labels this statement \"Conditional recommendation, moderate- to high-certainty evidence\". It is a suggestion, weaker than 1a and 1b. The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, third statement (part 1)", "evidence_role": "supports", "applicability_note": "The population WHO suggests treating." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, third statement (part 2)", "evidence_role": "supports", "applicability_note": "The systolic range." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, third statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Conditional recommendation, moderate- to high-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 19, section 3.1, recommendation 1, implementation remarks", "evidence_role": "context", "applicability_note": "WHO implementation remark that applies to recommendation 1." } ] }, { "id": "cardio:claim-who-2021-r4", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "category": "recommendation", "statement": "WHO recommends that adults with hypertension who need medicine start with a drug from any of three classes: thiazide and thiazide-like agents, ACE inhibitors or angiotensin-receptor blockers, or long-acting dihydropyridine calcium channel blockers.", "evidence_stage": "guidance", "certainty": "high", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Strong recommendation, high-certainty evidence\". The certainty above is that label. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, statement (part 1)", "evidence_role": "supports", "applicability_note": "Who the recommendation covers." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, statement (part 2)", "evidence_role": "supports", "applicability_note": "The initial-treatment wording." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, class 1", "evidence_role": "supports", "applicability_note": "First class." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, class 2", "evidence_role": "supports", "applicability_note": "Second class." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, class 3", "evidence_role": "supports", "applicability_note": "Third class." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 23, section 3.4, recommendation 4, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Strong recommendation, high-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2021-r5", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "category": "recommendation", "statement": "WHO suggests that adults with hypertension who need medicine start with combination therapy, preferably as a single-pill combination, with the drugs chosen from diuretics (thiazide or thiazide-like), ACE inhibitors or angiotensin-receptor blockers, and long-acting dihydropyridine calcium channel blockers.", "evidence_stage": "guidance", "certainty": "moderate", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Conditional recommendation, moderate-certainty evidence\". The certainty above is that label. It sits beside recommendation 4, which allows a start with a single drug from any of the classes; the page shows both. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 25, section 3.5, recommendation 5, statement (part 1)", "evidence_role": "supports", "applicability_note": "Who and what WHO suggests." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 25, section 3.5, recommendation 5, statement (part 2)", "evidence_role": "supports", "applicability_note": "The single-pill preference and its stated reason." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 25, section 3.5, recommendation 5, statement (part 3)", "evidence_role": "supports", "applicability_note": "The three drug classes to choose from." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 25, section 3.5, recommendation 5, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Conditional recommendation, moderate-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2021-r6a", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-to-target", "context_id": "cardio:ctx-who-2021-adults-hypertension-no-comorbidities", "category": "recommendation", "statement": "WHO recommends a blood pressure target of below 140/90 mmHg for adults with hypertension who have no comorbidities.", "evidence_stage": "guidance", "certainty": "moderate", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Strong recommendation, moderate-certainty evidence\". The certainty above is that label. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: \"In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets\", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. Statements 6b and 6c set a lower systolic target for two other groups. NICE sets its own target in a separate claim. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, first statement", "evidence_role": "supports", "applicability_note": "The target and the population." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, first statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Strong recommendation, moderate-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, Evidence and rationale, sentence on comorbidity (CAD, DM, CKD)", "evidence_role": "context", "applicability_note": "The comorbidities WHO names beside the statement." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2021-r6b", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-to-target", "context_id": "cardio:ctx-who-2021-adults-hypertension-with-cvd", "category": "recommendation", "statement": "WHO recommends a systolic blood pressure target of below 130 mmHg for adults with hypertension and known cardiovascular disease.", "evidence_stage": "guidance", "certainty": "moderate", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Strong recommendation, moderate-certainty evidence\". The certainty above is that label. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, second statement", "evidence_role": "supports", "applicability_note": "The target and the population." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, second statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Strong recommendation, moderate-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2021-r6c", "owner": "cardio", "subject_entity_id": "cardio:bp-lowering-to-target", "context_id": "cardio:ctx-who-2021-adults-hypertension-high-risk", "category": "recommendation", "statement": "WHO suggests a systolic blood pressure target of below 130 mmHg for adults with hypertension who are at high risk because of high cardiovascular risk, diabetes or chronic kidney disease.", "evidence_stage": "guidance", "certainty": "moderate", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Conditional recommendation, moderate-certainty evidence\". It is a suggestion, weaker than 6a and 6b. The certainty above is that label. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, third statement (part 1)", "evidence_role": "supports", "applicability_note": "The target and the population." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, third statement (part 2)", "evidence_role": "supports", "applicability_note": "The remaining high-risk conditions." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 28, section 3.6, recommendation 6, third statement, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Conditional recommendation, moderate-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2021-r8", "owner": "cardio", "subject_entity_id": "cardio:nonphysician-hypertension-treatment", "context_id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "category": "recommendation", "statement": "WHO suggests that medicine for hypertension can be provided by nonphysician professionals such as pharmacists and nurses, provided there is proper training, prescribing authority, specific management protocols and physician oversight.", "evidence_stage": "guidance", "certainty": "low", "certainty_method": "The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.", "limitations": "WHO labels this statement \"Conditional recommendation, low-certainty evidence\". The certainty above is that label. The conditions are part of the recommendation, and none of them was checked against any country's rules. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved.", "editorial_state": "draft", "checked_at": "2026-10-11", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 31, section 3.8, recommendation 8, statement (part 1)", "evidence_role": "supports", "applicability_note": "Who may provide treatment." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 31, section 3.8, recommendation 8, statement (part 2)", "evidence_role": "supports", "applicability_note": "The conditions that must be met." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 31, section 3.8, recommendation 8, strength label", "evidence_role": "context", "applicability_note": "The strength label WHO prints under the statement: Conditional recommendation, low-certainty evidence" }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 2, sentence 2", "evidence_role": "context", "applicability_note": "WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle." }, { "snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "locator": "PDF page 9, Executive summary, paragraph 4, sentence 4", "evidence_role": "context", "applicability_note": "WHO says it built summary of findings tables with the GRADE approach." } ] }, { "id": "cardio:claim-who-2025-lsss", "owner": "cardio", "subject_entity_id": "cardio:salt-substitution", "context_id": "cardio:ctx-who-2025-adults-general-population", "category": "recommendation", "statement": "If adults in a general population choose to use table salt, WHO suggests replacing regular table salt with a lower-sodium salt substitute that contains potassium. This is a conditional recommendation, made alongside WHO's strong recommendation to keep sodium intake below 2 g a day. It is not intended for pregnant women, children, or people with kidney impairment or other conditions that might make it harder to clear potassium.", "evidence_stage": "guidance", "certainty": "low", "certainty_method": "Stated by WHO in the guideline rationale, which describes the evidence behind this recommendation as \"moderate-to-low certainty (an assessment of low certainty overall ...)\". The atlas records the overall assessment, low. This is WHO's assessment, not an atlas reviewer judgement.", "limitations": "WHO describes the evidence behind the recommendation as \"moderate-to-low certainty (an assessment of low certainty overall ...)\". The per-outcome levels are in WHO's Annex 6 GRADE table, which this record does not extract. It covers table salt that a person adds to food, not condiments such as soy sauce or sodium already in manufactured foods and restaurant meals. All trials in WHO's review excluded people who could be harmed by extra potassium and some also excluded people with diabetes, so evidence for those groups is uncertain. WHO says reducing sodium from all sources is the preferred strategy, and that a household member at risk of hyperkalaemia should not have food prepared with a substitute. It is recorded beside the NICE caution and does not resolve it.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, WHO recommendation box, page ix (recommendation sentence)", "evidence_role": "supports", "applicability_note": "The recommendation as worded, with its condition." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, WHO recommendation box, page ix (scope sentences)", "evidence_role": "context", "applicability_note": "Adults, not pregnant women or children, excluding kidney impairment." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, Scope of the recommendation, page ix", "evidence_role": "context", "applicability_note": "Discretionary use of table salt only; condiments are outside the scope." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, Rationale, first bullet, page xi", "evidence_role": "supports", "applicability_note": "WHO states low certainty overall under GRADE." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, Rationale, bullet 5, page xii", "evidence_role": "supports", "applicability_note": "WHO says the recommendation is conditional because the certainty was low." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, The evidence, page viii", "evidence_role": "context", "applicability_note": "Trials excluded people who could be harmed by extra potassium." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, Remarks, bullet 1, page xii", "evidence_role": "context", "applicability_note": "Reducing sodium from all sources is preferred." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, Remarks, last bullet, page xiii", "evidence_role": "context", "applicability_note": "Household members at risk of hyperkalaemia." }, { "snapshot_id": "cardio:who-pub-9789240105591-2026-10-11", "locator": "Page header, date line", "evidence_role": "context", "applicability_note": "Publication date shown on the WHO page." } ] }, { "id": "cardio:claim-who-sodium-under-2g", "owner": "cardio", "subject_entity_id": "cardio:high-sodium-intake", "context_id": "cardio:ctx-who-adults-sodium-intake", "category": "recommendation", "statement": "WHO recommends that adults reduce sodium intake to below 2 g a day, about 5 g of salt, to lower blood pressure and the risk of heart and blood-vessel disease. WHO calls this a strong recommendation and restates it in its 2025 salt-substitute guideline.", "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The 2025 guideline restates the limit; the strong recommendation itself comes from the 2012 WHO guideline, which this claim cites. In its recommendation remarks that PDF rates the evidence on sodium and blood pressure as high quality, and the evidence on sodium and all-cause mortality, cardiovascular disease, stroke and coronary heart disease as lower quality. Its Annex 1 GRADE table for intake below 2 g a day against 2 g or more in adults says that no study addressed that question with cardiovascular disease or stroke as its outcome. The table rates resting systolic blood pressure at 3.47 mmHg lower from 2 studies, graded high, and has no estimate for any cardiovascular event outcome. A footnote to that table reports 5 cohort studies that compared the two intake levels, with a risk ratio of 1.30 (1.03 to 1.64) for stroke at 2 g a day or more, and the table gives that cohort result no GRADE rating. Annex 8 of the PDF describes evidence of high and moderate quality that intake below 2 g a day is beneficial for blood pressure and for the risk of cardiovascular disease, stroke and coronary heart disease in adults. It rates the cardiovascular part as moderate quality on the basis of the blood-pressure evidence, citing the well-established link between blood pressure and cardiovascular outcomes. WHO gives no single certainty rating for the 2 g limit, so the certainty stays not assessed. The 2012 text applies the limit to pregnant and lactating women too, which is outside this context. The limit is for general populations and excludes people on supervised diets or with illnesses that affect body sodium.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, aligned WHO recommendations on sodium intake, page x", "evidence_role": "supports", "applicability_note": "The limit as restated in 2025." }, { "snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "locator": "Executive summary, WHO recommendation box, page ix (rationale sentence)", "evidence_role": "supports", "applicability_note": "Why WHO recommends it: blood pressure and cardiovascular risk." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Executive summary, Background, paragraph 1", "evidence_role": "context", "applicability_note": "The 2012 guideline gives 2 g of sodium a day, equal to 5 g of salt." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Executive summary, Recommendations remarks, page 3, paragraph 1", "evidence_role": "context", "applicability_note": "Who the 2012 recommendation applies to and its exceptions." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Executive summary, Recommendations remarks, page 3, paragraph 4", "evidence_role": "context", "applicability_note": "WHO's statement of the quality of the evidence behind the 2012 recommendations." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Annex 1, GRADE table for intake below 2 g/day against 2 g/day or more in adults (PDF page 32), outcome rows and notes", "evidence_role": "context", "applicability_note": "No study had cardiovascular disease or stroke as its outcome; blood pressure rated high; a footnote reports cohort studies." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Summary of evidence, page 12, comparison of the lowest with the middle consumption group", "evidence_role": "context", "applicability_note": "The blood-pressure difference for below 2 g a day, with WHO's high quality rating." }, { "snapshot_id": "cardio:who-sodium-2012-pdf-2026-10-11", "locator": "Annex 8, Quality of evidence, page 37", "evidence_role": "context", "applicability_note": "WHO's summary of evidence quality when it set the strength of the recommendation." } ] } ], "contexts": [ { "id": "cardio:ctx-aha-acc-2025-adults", "label": "Adults (2025 AHA/ACC high blood pressure guideline)", "recipient": "adult", "population": "Adults, as the guideline title states. The abstract gives no inclusion or exclusion criteria, so age limits, special populations and pregnancy handling are not known from the sources read.", "care_setting": "Aimed at primary care and specialty clinicians who manage patients with hypertension, as the abstract states", "geography": "Not stated in the abstract (issued by American societies; jurisdiction not verified)", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (guideline context)", "eligibility": { "inclusion": [ "Adults (from the guideline title)" ], "exclusion": [] } }, { "id": "cardio:ctx-bplttc-trial-participants", "label": "Participants in 48 randomised blood-pressure-lowering trials (BPLTTC 2021 meta-analysis)", "recipient": "unknown", "population": "People randomised in 48 trials of blood-pressure-lowering medicines, analysed in two groups: those with and those without previous cardiovascular disease, defined as stroke, myocardial infarction or ischaemic heart disease before randomisation. Mean age at baseline was 65 years in both groups. The age range is not reported in the text read, which does not describe the participants as adults, and it does not say how pregnancy was handled.", "care_setting": "Randomised clinical trials of blood-pressure-lowering medicines. The settings of the individual trials are listed in the paper's appendix, which was not read.", "geography": "Not stated in the text read (the trial list is in the appendix, which was not read)", "life_stage": "Not stated in the text read; mean age 65 years at baseline, age range not reported", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up of 4.15 years across the trials (Q1 to Q3 2.97 to 4.96 years).", "eligibility": { "inclusion": [ "Trials that randomised people to blood-pressure-lowering medicines versus placebo or another class, or to more versus less intensive treatment", "Trials with at least 1000 person-years of follow-up in each randomised group", "Trials that shared baseline blood pressure, primary and secondary outcomes, and whether previous cardiovascular disease was present" ], "exclusion": [ "Trials done only in people with heart failure", "Short-term trials in acute myocardial infarction or other acute settings", "People with known heart failure at baseline, in trials that had included them" ] } }, { "id": "cardio:ctx-esc-2024-adults", "label": "Adults with elevated blood pressure or hypertension (2024 ESC guideline)", "recipient": "adult", "population": "Adults with elevated blood pressure or hypertension. Age limits and pregnancy handling are not stated in the sources read.", "care_setting": "Not stated in the sources read", "geography": "Not stated in the sources read (guideline of the European Society of Cardiology; applicability by country not verified)", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (guideline context)", "eligibility": { "inclusion": [ "Adults with elevated blood pressure or hypertension" ], "exclusion": [] } }, { "id": "cardio:ctx-esh-cuffless-population-unstated", "label": "People the European Society of Hypertension cuffless-device statements address (population not stated)", "recipient": "unknown", "population": "Not stated in the fetched abstracts. Neither abstract names a patient population.", "care_setting": "Not stated in the fetched abstracts", "geography": "Not stated in the fetched abstracts", "life_stage": "Not stated in the fetched abstracts", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (expert statements)", "eligibility": { "inclusion": [], "exclusion": [] } }, { "id": "cardio:ctx-fda-k001848-us-clearance", "label": "United States 510(k) clearance record K001848 for the Omron HEM-907", "recipient": "unknown", "population": "Not stated in the FDA record. The record names a device and an applicant, and gives no intended population.", "care_setting": "Not stated in the FDA record", "geography": "United States (decision by the US Food and Drug Administration)", "life_stage": "Not stated in the FDA record", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (regulatory decision)", "eligibility": { "inclusion": [], "exclusion": [] } }, { "id": "cardio:ctx-hem907-validation-2002", "label": "People measured in the 2002 validation study of the Omron HEM-907", "recipient": "unknown", "population": "33 people in the final phase of the validation, as the abstract counts them. The abstract does not describe who they were.", "care_setting": "Not stated in the abstract", "geography": "Not stated in the abstract", "life_stage": "Not stated in the abstract", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not stated in the abstract. The abstract describes two observers measuring at the same time, alternating with the device, and gives no follow-up period.", "eligibility": { "inclusion": [], "exclusion": [] } }, { "id": "cardio:ctx-nice-adults-suspected-hypertension", "label": "Adults with suspected hypertension, clinic blood pressure 140/90 to 180/120 mmHg (NICE NG136 1.2)", "recipient": "adult", "population": "Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.", "care_setting": "Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)", "geography": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.", "life_stage": "Adult (aged 18 and over)", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult aged 18 and over (NICE NG136 Overview chapter)", "Clinic blood pressure between 140/90 mmHg and 180/120 mmHg (recommendations 1.2.3 and 1.2.4)", "With or without type 2 diabetes (introductory text to the NG136 recommendations)" ], "exclusion": [ "Pregnancy is outside this atlas context. NICE has a separate guideline on hypertension in pregnancy, and the fetched diagnosis recommendations state no separate pregnancy exclusion.", "A clinic blood pressure of 180/120 mmHg or higher is handled in the NG136 referral section, which this context does not cover." ] } }, { "id": "cardio:ctx-nice-adults-under-80-hypertension", "label": "Adults with hypertension aged under 80 (NICE NG136 recommendation 1.4.20)", "recipient": "adult", "population": "Adults with hypertension aged under 80, with or without type 2 diabetes (NG136 Table 1)", "care_setting": "Not stated on the fetched page", "geography": "Not stated on the fetched page (NICE guidance; jurisdiction not verified)", "life_stage": "Adult under 80", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult with hypertension", "Aged under 80", "With or without type 2 diabetes (NG136 Table 1)" ], "exclusion": [] } }, { "id": "cardio:ctx-nice-ng136-adults-hypertension-potassium-substitute-groups", "label": "Adults with suspected or diagnosed hypertension who are older, have diabetes or kidney disease, or take some blood-pressure medicines (NICE NG136 recommendation 1.4.5)", "recipient": "adult", "population": "Adults with suspected or diagnosed hypertension in the groups NICE names for potassium chloride salt substitutes: older people (NICE gives no age), people with diabetes, people with kidney disease, and people on some blood-pressure medicines (for example ACE inhibitors and angiotensin II receptor blockers). The recommendation says people and sits in the lifestyle section addressed to people with suspected or diagnosed hypertension. NICE also names pregnant women; that group is outside this context and belongs to the maternal atlas.", "care_setting": "Not stated on the fetched page", "geography": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.", "life_stage": "Adult; older people are named but NICE gives no age bound", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult with suspected or diagnosed hypertension", "At least one of: older age, diabetes, kidney disease, or taking some antihypertensive drugs such as ACE inhibitors or angiotensin II receptor blockers" ], "exclusion": [ "Pregnant women are named by NICE but belong to the maternal atlas" ] } }, { "id": "cardio:ctx-nice-ng136-adults-measuring-bp", "label": "Adults whose blood pressure is measured (NICE NG136 recommendation 1.1.3)", "recipient": "adult", "population": "All adults, including those with type 2 diabetes, as the NG136 introduction states for its recommendations on measuring blood pressure and diagnosing hypertension. This atlas does not narrow that statement. Care in pregnancy belongs to the maternal atlas, and no claim here is about it.", "care_setting": "Not stated on the fetched page. Recommendation 1.1.3 is addressed to healthcare providers.", "geography": "Not stated on the fetched page (NICE guidance; jurisdiction not verified)", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "With or without type 2 diabetes" ], "exclusion": [] } }, { "id": "cardio:ctx-sprint-adults-50plus-high-cv-risk-no-diabetes", "label": "Adults 50 and over with raised systolic blood pressure and increased cardiovascular risk, without diabetes or prior stroke (SPRINT)", "recipient": "adult", "population": "Adults aged 50 years or older with systolic blood pressure of 130 to 180 mm Hg (the registry lowers the upper limit as the number of blood-pressure medicines rises) and at least one increased-risk criterion, excluding diabetes mellitus and prior stroke.", "care_setting": "Outpatient trial clinics at 102 clinical sites. Nursing-home and assisted-living residents were not enrolled.", "geography": "United States, including Puerto Rico", "life_stage": "Adult, 50 years and over (28.2% of each arm aged 75 or over, per Table 1 of the paper)", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up 3.26 years when the blood-pressure intervention was stopped early on 2015-08-20. The registry gives a planned maximum follow-up of 6 years. Mean systolic pressure at 1 year was 121.4 mm Hg (intensive) and 136.2 mm Hg (standard).", "eligibility": { "inclusion": [ "Age 50 years or older", "Systolic blood pressure 130 to 180 mm Hg (paper). Registry upper limits by number of blood-pressure medicines: 0 to 1 medicines 130 to 180, up to 2 medicines 130 to 170, up to 3 medicines 130 to 160, up to 4 medicines 130 to 150.", "At least one increased cardiovascular risk criterion: clinical or subclinical cardiovascular disease other than stroke; chronic kidney disease (excluding polycystic kidney disease); Framingham 10-year cardiovascular risk of 15% or greater; or older age.", "Kidney criterion, worded differently by the sources and not reconciled: paper eGFR 20 to less than 60 ml/min/1.73 m2 (4-variable MDRD); registry \"CKD, defined as eGFR 20 - 59 ml/min/1.73m2\".", "Age criterion, worded differently by the sources and not reconciled: paper \"an age of 75 years or older\"; registry \"Age greater than 75 years\".", "Sex: all (registry)" ], "exclusion": [ "Diabetes mellitus", "Prior stroke (registry: \"History of stroke (not CE or stenting)\")", "Symptomatic heart failure within 6 months or left ventricular ejection fraction below 35% (registry)", "Proteinuria above the registry thresholds", "eGFR below 20 or end-stage renal disease (registry)", "Polycystic kidney disease (registry)", "One-minute standing systolic blood pressure below 110 mm Hg (registry)", "Pregnancy or trying to become pregnant (registry)" ] } }, { "id": "cardio:ctx-ssass-rural-china-stroke-or-60plus-hbp", "label": "People with a past stroke, or aged 60 or over with high blood pressure, in rural Chinese villages (SSaSS)", "recipient": "unknown", "population": "People who had had a stroke, or who were 60 years of age or older and had high blood pressure, living in rural villages in China. The registry defines high blood pressure as uncontrolled: systolic 140 mmHg or more on treatment, or 160 mmHg or more without treatment. In the trial 72.6% had a history of stroke and 88.4% a history of hypertension, and the mean age was 65.4 years. No source read gives a minimum age, and the past-stroke group has no stated age floor, so the recipient is recorded as unknown rather than adult. Pregnancy is not mentioned in the sources read.", "care_setting": "Rural villages in China, 600 of them. The registry names five Northern Chinese provinces and Tibet. A household phone was an entry requirement.", "geography": "Rural China: five Northern Chinese provinces and Tibet (registry description)", "life_stage": "Mixed ages with a mean of 65.4 years. Age 60 or over is required for people without a past stroke; no age floor is stated for people with one.", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Mean follow-up 4.74 years (abstract). The registry gives a time frame of 5 years.", "eligibility": { "inclusion": [ "Past stroke, or aged 60 years or over with uncontrolled high blood pressure (systolic 140 mmHg or more on blood-pressure medicine, 160 mmHg or more without)", "Abstract wording: a history of stroke, or 60 years of age or older with high blood pressure", "A phone owned by the participant or a household member" ], "exclusion": [ "Participant or family member using a potassium-sparing diuretic", "Participant or family member using a potassium supplement", "Participant or family member with serious renal impairment", "Participant or family member with another reason for concern about using a salt substitute", "Participant eats most meals outside the home", "Not expected to live longer than 6 months, as estimated by the village doctor", "Another family member in the same household already included" ] } }, { "id": "cardio:ctx-who-2012-general-statement", "label": "General statement in the WHO 2012 sodium guideline (no population stated)", "recipient": "unknown", "population": "The background passages state no population. They are general statements in a guideline about sodium intake in adults and children, so the claim is not scoped to an age group or to pregnancy.", "care_setting": "Not stated in the source", "geography": "Not stated in the source", "life_stage": "Not stated in the source", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (background statement)", "eligibility": { "inclusion": [], "exclusion": [] } }, { "id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "label": "Adults with confirmed hypertension (WHO 2021 recommendations 1a, 4, 5 and 8)", "recipient": "adult", "population": "Adults with a confirmed diagnosis of hypertension. Recommendation 1a covers systolic 140 mmHg or higher or diastolic 90 mmHg or higher. Recommendations 4, 5 and 8 cover adults with hypertension who need medicine. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed and counselled about lifestyle changes.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "Confirmed diagnosis of hypertension", "Counselled about lifestyle modifications (WHO scope statement)" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2021-adults-cvd-sbp-130-139", "label": "Adults with existing cardiovascular disease and systolic 130 to 139 mmHg (WHO 2021 recommendation 1b)", "recipient": "adult", "population": "Adults with existing cardiovascular disease and a systolic blood pressure of 130 to 139 mmHg. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed with hypertension.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "Existing cardiovascular disease", "Systolic blood pressure of 130 to 139 mmHg" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2021-adults-high-risk-sbp-130-139", "label": "Adults without cardiovascular disease but at high risk, with diabetes or with chronic kidney disease, systolic 130 to 139 mmHg (WHO 2021 recommendation 1c)", "recipient": "adult", "population": "Adults without cardiovascular disease who have high cardiovascular risk, diabetes mellitus or chronic kidney disease, and a systolic blood pressure of 130 to 139 mmHg. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed with hypertension.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "No cardiovascular disease", "High cardiovascular risk, or diabetes mellitus, or chronic kidney disease", "Systolic blood pressure of 130 to 139 mmHg" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2021-adults-hypertension-high-risk", "label": "Adults with hypertension at high risk (WHO 2021 recommendation 6c)", "recipient": "adult", "population": "Adults with hypertension who are at high risk, which WHO lists as high cardiovascular risk, diabetes mellitus or chronic kidney disease. WHO says the guideline targets non-pregnant adults.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "Hypertension", "High cardiovascular risk, or diabetes mellitus, or chronic kidney disease" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2021-adults-hypertension-no-comorbidities", "label": "Adults with hypertension without comorbidities (WHO 2021 recommendation 6a)", "recipient": "adult", "population": "Adults with hypertension and no comorbidities. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: \"In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets\", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. WHO says the guideline targets non-pregnant adults.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "Hypertension", "No comorbidities" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2021-adults-hypertension-with-cvd", "label": "Adults with hypertension and known cardiovascular disease (WHO 2021 recommendation 6b)", "recipient": "adult", "population": "Adults with hypertension and known cardiovascular disease. WHO says the guideline targets non-pregnant adults.", "care_setting": "Not stated for this recommendation in the source", "geography": "Global WHO guidance; national adoption not recorded", "life_stage": "Adult", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Adult", "Hypertension", "Known cardiovascular disease" ], "exclusion": [ "Pregnant patients: WHO says the recommendations target non-pregnant patients" ] } }, { "id": "cardio:ctx-who-2025-adults-general-population", "label": "Adults in general populations, not pregnant, without kidney impairment (WHO 2025 salt-substitute guideline)", "recipient": "adult", "population": "Adults in general populations. The recommendation excludes pregnant women, children, and people with kidney impairment or other circumstances or conditions that might compromise potassium excretion.", "care_setting": "Not stated as a care setting. The recommendation concerns table salt that a person adds to food while cooking or eating.", "geography": "Global guideline; no country is specified", "life_stage": "Adult; the guideline states no age bounds and excludes children", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context). The trials behind it followed adults from 56 days to 5 years.", "eligibility": { "inclusion": [ "Adults in general populations who choose to use table salt" ], "exclusion": [ "Pregnant women", "Children", "People with kidney impairment", "People with other circumstances or conditions that might compromise potassium excretion", "Households where a member is at risk of hyperkalaemia, for family meals" ] } }, { "id": "cardio:ctx-who-adults-sodium-intake", "label": "Adults in general populations (WHO sodium intake guidance, 2012 and its 2025 restatement)", "recipient": "adult", "population": "Adults in the general population, with or without hypertension. The 2012 text also applies the recommendation to pregnant and lactating women; that item belongs to the maternal atlas and is outside this context. The 2012 text excludes people with illnesses or medicines that can cause low blood sodium or sudden fluid retention, and people who need physician-supervised diets, such as people with heart failure or type 1 diabetes.", "care_setting": "Not stated as a care setting. The guidance covers everyday dietary sodium intake.", "geography": "Global guidance. The cohort studies in the 2012 meta-analysis were conducted in Europe, Japan and the United States.", "life_stage": "Adult; the sources set no age bounds in the passages read", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable to the recommendation. The cohort studies in the 2012 summary followed adults for 3.8 to 22 years.", "eligibility": { "inclusion": [ "Adults", "With or without hypertension" ], "exclusion": [ "Illnesses or medicines that can cause low blood sodium or sudden fluid retention", "People who need physician-supervised diets (for example heart failure, type 1 diabetes)", "Pregnancy and lactation: named by the 2012 text, outside this context" ] } } ], "sources": [ { "id": "cardio:aha-acc-2025-hbp", "source_type": "guideline", "title": "2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults", "canonical_url": "https://doi.org/10.1161/CIR.0000000000001356", "identifier_namespace": "doi", "identifier_value": "10.1161/CIR.0000000000001356", "publication_date": "2025-09-16", "publisher": "Ovid Technologies (Wolters Kluwer Health)", "edition": "Issued by the American College of Cardiology and the American Heart Association with other societies named in the title. Published in Circulation 152(11):e114-e218 and co-published in JACC 86(18):1567-1678. The publisher field is the Circulation publisher as Crossref names it. Abstract and bibliographic records only. The Circulation abstract comes from PubMed (electronic publication 2025-08-14, issue date 2025-09-16). The JACC co-publication is known from Crossref. Both publisher pages returned HTTP 403 and Europe PMC lists the full text as subscription required, so the guideline text was not read. PubMed lists three corrections to the Circulation version (2025-11-11, 2026-04-14 and 2026-05-26) and Crossref lists two to the JACC version. None of their text was read.", "reuse_basis": "Bibliographic metadata and short quotations from the PubMed abstract, under 25 words each. Full text not reachable and not redistributed. Hashes only; nothing is committed. The societies' reuse terms were not reviewed. Public text is quote under the PubMed abstract rule: only short quotations from the PubMed abstract (under 25 words each) are used, with attribution.", "public_text": "quote", "snapshots": [ { "id": "cardio:pubmed-40811497-2026-10-11", "retrieved_at": "2026-10-11T19:12:26Z", "content_hash": "9e027f3d68d4bfdb87610ed25b0bc4da961cdb43254f5421faf962074220c710", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:crossref-jacc-2025-05-007-2026-10-11", "retrieved_at": "2026-10-11T19:12:28Z", "content_hash": "09bef8125ff0d467b57cbcd98e3d62e6a6f74fdabbbbbee3689a5288a8e8269f", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:crossref-cir-1356-2026-10-12", "retrieved_at": "2026-10-12T12:54:11Z", "content_hash": "b7608b03bc48b03ebb26de31656181daf7dbfe34d01d581ad403ad2f8db39b03", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" } ] }, { "id": "cardio:bplttc-lancet-2021-erratum", "source_type": "publication", "title": "Department of Error: erratum to the BPLTTC individual participant-level data meta-analysis (Lancet 2021)", "canonical_url": "https://doi.org/10.1016/S0140-6736(21)01069-2", "identifier_namespace": "doi", "identifier_value": "10.1016/S0140-6736(21)01069-2", "publication_date": "2021-05-22", "publisher": "Elsevier (The Lancet 397(10288):1884)", "edition": "PubMed publication type Published Erratum. The notice says the collaboration group list was updated and the change was made to the online version as of May 20, 2021. It states no change to any result.", "reuse_basis": "CC BY, stated in the PMC permissions element (an open access article under the CC BY license). The PMC XML is committed at research/snapshots/cd-pmc-PMC8165755-erratum.xml. Attribution: The Blood Pressure Lowering Treatment Trialists' Collaboration, Department of Error, Lancet 2021;397:1884, doi 10.1016/S0140-6736(21)01069-2, via PMC (PMC8165755). The PubMed record is kept as a hash only.", "public_text": "quote", "snapshots": [ { "id": "cardio:pmc-pmc8165755-2026-10-11", "retrieved_at": "2026-10-11T19:11:47Z", "content_hash": "2201a9c966a07582e5f1e3d4fc8146b45461c002250e9b1c46906d12a954ff67", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:pubmed-34022983-2026-10-11", "retrieved_at": "2026-10-11T19:12:23Z", "content_hash": "94bbd64de0e3f5a41eb4d8e457f077c3d8c9e5bc1b474c0ae14158e6e9d1a92e", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:bplttc-lancet-2021", "source_type": "publication", "title": "Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis", "canonical_url": "https://doi.org/10.1016/S0140-6736(21)00590-0", "identifier_namespace": "doi", "identifier_value": "10.1016/S0140-6736(21)00590-0", "publication_date": "2021-05-01", "publisher": "Elsevier BV", "edition": "Authored by the Blood Pressure Lowering Treatment Trialists' Collaboration and published in The Lancet 397(10285):1625-1636. The publisher field is the journal publisher as Crossref names it. The open-access PMC version (PMC8102467), fetched through NCBI efetch. The publisher pages were not readable: the DOI redirect returned only a redirect page and sciencedirect.com returned HTTP 403, so the version of record was not read. PubMed lists one published erratum (a Department of Error notice), which only updates the collaboration group list; it is a separate source in this atlas. Figure 3, which shows each component outcome including stroke alone, is an image that was not read. The publication date is the issue date.", "reuse_basis": "CC BY 4.0, stated in the PMC permissions element (an open access article under the CC BY 4.0 license, 2021 The Author(s), published by Elsevier). The PMC XML is committed at research/snapshots/cd-pmc-PMC8102467.xml. Attribution: The Blood Pressure Lowering Treatment Trialists' Collaboration, Lancet 2021;397:1625-1636, doi 10.1016/S0140-6736(21)00590-0, via PMC (PMC8102467). The XML carries one corresponding-author email address exactly as published; this atlas does not repeat it. The PubMed record is kept as a hash only.", "public_text": "quote", "snapshots": [ { "id": "cardio:pmc-pmc8102467-2026-10-11", "retrieved_at": "2026-10-11T19:11:47Z", "content_hash": "0531fab89a3769c062eb6e5a2a9b11a8c670c67811bcef1c6959884f3522cf03", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:pubmed-33933205-2026-10-11", "retrieved_at": "2026-10-11T19:11:47Z", "content_hash": "bc30be2089354d0478e7dbd44e0563393deae35ec37f145a54f1ab94b4904ae1", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:crossref-bplttc-2026-10-12", "retrieved_at": "2026-10-12T12:54:12Z", "content_hash": "92d58aff9f0b2906747108fe24d9b9c37f2b7a680da00685383202296d892433", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" } ] }, { "id": "cardio:esc-2024-hypertension", "source_type": "guideline", "title": "2024 ESC Guidelines for the management of elevated blood pressure and hypertension", "canonical_url": "https://doi.org/10.1093/eurheartj/ehae178", "identifier_namespace": "doi", "identifier_value": "10.1093/eurheartj/ehae178", "publication_date": "2024-08-30", "publisher": "Oxford University Press (OUP)", "edition": "Issued by the European Society of Cardiology and published in European Heart Journal 45(38):3912-4018. The publisher field is the journal publisher as Crossref names it. Publisher summary only. The version of record was not read: doi.org and academic.oup.com returned HTTP 403 (a Cloudflare challenge), PubMed holds no abstract for it, and Europe PMC lists it as subscription required. The facts come from the ESC Essential Messages PDF for this guideline, found through the ESC Essential messages page, and from the ESC guideline page. Two later corrections are listed in PubMed (Eur Heart J 2025 Apr 7;46(14):1300, doi 10.1093/eurheartj/ehaf031, and 2025 Dec 1;46(45):4949, doi 10.1093/eurheartj/ehaf659). Their text was not read, and the Essential Messages was produced before both.", "reuse_basis": "Hashes only and nothing committed. The ESC states that its guidelines are protected by copyright, are for personal and educational use with no commercial use, and that it reserves the right to license use of its guidelines for training generative AI (EU Directive 2019/790, Article 4 section 3). Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the ESC's recommendations in the atlas's own words, with a citation and a link, and use no ESC wording.", "public_text": "cite_only", "snapshots": [ { "id": "cardio:pubmed-39210715-2026-10-11", "retrieved_at": "2026-10-11T19:12:57Z", "content_hash": "f9afb12c7dd4e0a09ed8cba2fbbc89cf98fe1655ea1bfe1bb04012b061740281", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:esc-guideline-page-2026-10-11", "retrieved_at": "2026-10-11T19:13:03Z", "content_hash": "06bcd4ebdc3eb0f68f2fd1e2c0fa308e22cc89ced3a50dc40fff1096e4500d30", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:esc-essential-messages-2026-10-11", "retrieved_at": "2026-10-11T19:13:32Z", "content_hash": "1002525ded65298879e25304fbc88d4af91631b7dd4977df3ec2e67f504ffd98", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, { "id": "cardio:crossref-esc-2024-2026-10-12", "retrieved_at": "2026-10-12T12:54:12Z", "content_hash": "2c10b7c79e5fa5027fbe437db35c1759dcadcaa3587042b1dde810045589bfed", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" } ] }, { "id": "cardio:esh-cuffless-2022", "source_type": "publication", "title": "Cuffless blood pressure measuring devices: review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability (Stergiou and colleagues, Journal of Hypertension)", "canonical_url": "https://pubmed.ncbi.nlm.nih.gov/35708294/", "identifier_namespace": "pmid", "identifier_value": "35708294", "publication_date": "2022-08-01", "publisher": "Wolters Kluwer Health (Journal of Hypertension)", "edition": "Journal of Hypertension, August 2022 issue. The PubMed record and its abstract only. The full text was not fetched.", "reuse_basis": "The abstract carries a publisher copyright line, so only short quotations with attribution are used and only the sha256 of the PubMed record is kept. 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The FDA 510(k) database page for the same number was also fetched and gives the same number, applicant, product code, regulation number, clearance type and decision date. Only the openFDA JSON is kept as a snapshot.", "reuse_basis": "openFDA data is public domain under a Creative Commons CC0 1.0 Universal dedication, as the openFDA licence page states (fetched 2026-10-11, hash only). The raw record is committed at research/snapshots/ca-openfda-510k-k001848.json. It includes the 510(k) contact name that FDA publishes and long lists of establishment registration numbers for the product code. 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No file is committed.", "public_text": "quote", "snapshots": [ { "id": "cardio:pubmed-12198340-2026-10-11", "retrieved_at": "2026-10-11T19:11:59Z", "content_hash": "40b158f63ee3426124368d60b54951c88e37882f5b9b1556040d8b7484d893ae", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:nice-making-decisions", "source_type": "webpage", "title": "Making decisions using NICE guidelines", "canonical_url": "https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/making-decisions-using-nice-guidelines", "identifier_namespace": null, "identifier_value": null, "publication_date": null, "publisher": "National Institute for Health and Care Excellence (NICE)", "edition": null, "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only; outside it, apart from private use, study or one's own research, NICE's prior written agreement is needed.", "public_text": "cite_only", "snapshots": [ { "id": "cardio:nice-making-decisions-2026-10-09", "retrieved_at": "2026-10-09T15:59:49Z", "content_hash": "b7838d1bdb692f2b6dfc71480aa95803d68c64aa0dde406375953c9479aaae7c", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:nice-ng136-update-information", "source_type": "guideline", "title": "Hypertension in adults: diagnosis and management (NICE guideline NG136), Update information chapter", "canonical_url": "https://www.nice.org.uk/guidance/ng136/chapter/Update-information", "identifier_namespace": null, "identifier_value": null, "publication_date": null, "publisher": "National Institute for Health and Care Excellence (NICE)", "edition": "The chapter as fetched on 2026-10-11. The page header gives a last update of 26 February 2026. Its first entry is the February 2026 addition of recommendation 1.2.11.", "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE content may be reused outside the United Kingdom only for private use, study or one's own research unless NICE agrees in writing (see cardio:nice-terms-and-conditions). 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This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged [2004]; 1.2.3, 1.2.4 and 1.2.8 are tagged [2019]; 1.4.5 is tagged [2004, amended 2019]; 1.4.20 is tagged [2019, amended 2022]. Which edition of each recommendation these tags point to was not checked.", "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.", "public_text": "cite_only", "snapshots": [ { "id": "cardio:nice-ng136-recs-2026-10-09", "retrieved_at": "2026-10-09T15:59:21Z", "content_hash": "68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28", "source_effective_date": "2026-02-26", "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:nice-terms-and-conditions", "source_type": "webpage", "title": "NICE terms and conditions, including the Notice of Rights", "canonical_url": "https://www.nice.org.uk/terms-and-conditions", "identifier_namespace": null, "identifier_value": null, "publication_date": null, "publisher": "National Institute for Health and Care Excellence (NICE)", "edition": "The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.", "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. This page sets the terms under which NICE content may be reused; its wording is kept in research/cluster-b/quotes.tsv as internal evidence and is not published. 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The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read, so the redistribution basis is unverified. Public text is quote, following Ben's decision of 2026-10-13 (medical-atlas-core issue 2) that registries allow short quotations with attribution. 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The erratum text was not reachable.", "public_text": "quote", "snapshots": [ { "id": "cardio:pubmed-29262284-2026-10-09", "retrieved_at": "2026-10-09T15:57:08Z", "content_hash": "0b35286e25986a2083bf5e24855520256cee0d8b58ccbff94f1f70961857ff34", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:sprint-nejm-2015", "source_type": "publication", "title": "A Randomized Trial of Intensive versus Standard Blood-Pressure Control", "canonical_url": "https://doi.org/10.1056/NEJMoa1511939", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa1511939", "publication_date": "2015-11-26", "publisher": "Massachusetts Medical Society (N Engl J Med 373(22):2103-16)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed (electronic article date 2015-11-09). 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The JSON has no results section.", "reuse_basis": "Registry record, hash only. The ClinicalTrials.gov terms page is rendered by JavaScript and was not read, so the redistribution basis is unverified. The raw JSON is not committed, because that basis is unverified. Public text is quote, following Ben's decision of 2026-10-13 (medical-atlas-core issue 2) that registries allow short quotations with attribution. This source's terms are unverified or reserve all rights, so any quotation stays short.", "public_text": "quote", "snapshots": [ { "id": "cardio:ctgov-nct02092090-2026-10-11", "retrieved_at": "2026-10-11T19:11:27Z", "content_hash": "7fb59c0de28942b6334a4072776326676f525b7454e1d33a3c60ee6c7c4cf6d3", "source_effective_date": "2021-04-08", "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:ssass-nejm-2021", "source_type": "publication", "title": "Effect of Salt Substitution on Cardiovascular Events and Death", "canonical_url": "https://doi.org/10.1056/NEJMoa2105675", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2105675", "publication_date": "2021-09-16", "publisher": "Massachusetts Medical Society (N Engl J Med 385(12):1067-1077)", "edition": "Abstract only, from PubMed, fetched 2026-10-11. The published date is the print issue date; PubMed also gives an electronic publication date of 2021-08-29. The version of record at nejm.org returned HTTP 403. Europe PMC reports the article as not open access and not in PMC.", "reuse_basis": "Bibliographic metadata and short factual extraction with quotations under 25 words. The Crossref license link points to NEJM terms of use. 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The snapshot hash is the sha256 of the rendered page text as the browser showed it, not of the page's HTML. The home, about and principles pages carry no date. The terms page gives 15 January 2024 as its update date. The device page was reached by typing HEM-907 into the search box on the BP Monitors page and opening the result. The list snapshot is the unfiltered first page of the BP Monitors page, opened by its address. The terms, principles and list pages were each opened again on 2026-10-12 with identical hashes, and the log has a row for each of the three re-reads. An earlier scripted fetch of these pages on 2026-10-11 returned HTTP 403 and then HTTP 200 after the user agent was changed. Those scripted fetches are not used as evidence (see the research notes).", "reuse_basis": "All rights reserved, as the page footer states. The terms of use do not allow copying the service or incorporating its content into another site, do not allow searching it other than through its public interface (the site's own search box and device pages are read that way here), and do not allow circumventing its security measures. Nothing from the site is committed. Only sha256 hashes of the rendered text are kept. Public text is identity_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages give the name and a link only, and a claim that rests only on this site stays out of the public build.", "public_text": "identity_only", "snapshots": [ { "id": "cardio:stridebp-home-2026-10-12", "retrieved_at": "2026-10-12T12:54:19Z", "content_hash": "b37bd13ee32b8f8a22995e3fbe7b244016b0fc000c3705b06877e28604254b17", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:stridebp-about-2026-10-12", "retrieved_at": "2026-10-12T12:54:32Z", "content_hash": "b76f266b88fde071bfb786fcec362dedf71570e5b62772c8e9dc89fc9515a417", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:stridebp-principles-2026-10-12", "retrieved_at": "2026-10-12T12:54:44Z", "content_hash": "51d081799bac2f548fb97f69f0f24e1f0c7fefc35abe8c4eafd32664170f97a4", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:stridebp-terms-2026-10-12", "retrieved_at": "2026-10-12T12:54:56Z", "content_hash": "e6e44e9d75d40a383001e1a17c4ee04a4e95096579ce265a4ecd97aa0ade2ba1", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:stridebp-list-2026-10-12", "retrieved_at": "2026-10-12T13:14:53Z", "content_hash": "481e94331a81149457f1440174159612bb63dcd65aa4886fcc3ea077fada4c5c", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:stridebp-device-hem907-2026-10-12", "retrieved_at": "2026-10-12T13:14:41Z", "content_hash": "a2dddb8f7d18b0d3a97a76e63ea46c0f22b048700fc884874949a3b742d517c7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:who-2021-hypertension-pharmacological", "source_type": "guideline", "title": "Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021)", "canonical_url": "https://www.who.int/publications/i/item/9789240033986", "identifier_namespace": "isbn", "identifier_value": "978-92-4-003398-6", "publication_date": "2021-08-24", "publisher": "World Health Organization", "edition": "Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.", "reuse_basis": "CC BY-NC-SA 3.0 IGO, as the PDF states. Short quotations with attribution only. The non-commercial and share-alike terms need a decision on the atlas public data licence before any reuse beyond short quotation. Neither snapshot is committed.", "public_text": "quote", "snapshots": [ { "id": "cardio:who-pub-9789240033986-2026-10-11", "retrieved_at": "2026-10-11T19:11:37Z", "content_hash": "602dbae5a5133704717365dd7badfcc275bdc1df9c781e3e00b632131493f533", "source_effective_date": "2021-08-24", "public_archive_url": null, "source_state": "current" }, { "id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "retrieved_at": "2026-10-11T19:11:40Z", "content_hash": "57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb", "source_effective_date": "2021-08-24", "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:who-2025-lsss", "source_type": "guideline", "title": "Use of lower-sodium salt substitutes: WHO guideline", "canonical_url": "https://www.who.int/publications/i/item/9789240105591", "identifier_namespace": "isbn", "identifier_value": "978-92-4-010559-1", "publication_date": "2025-01-27", "publisher": "World Health Organization", "edition": "Guideline dated 27 January 2025 on the WHO page; English PDF from WHO IRIS, both fetched 2026-10-11. The PDF title page shows only the year 2025.", "reuse_basis": "CC BY-NC-SA 3.0 IGO, stated in the PDF. Short quotations with attribution only, until the atlas settles its public data licence. Hashes only; the page and the PDF are not committed.", "public_text": "quote", "snapshots": [ { "id": "cardio:who-pub-9789240105591-2026-10-11", "retrieved_at": "2026-10-11T19:11:28Z", "content_hash": "45cb6814f63da77e114e3dbc744dc1b8e2295a14f12cd9bc8c289216407d2c47", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, { "id": "cardio:who-lsss-pdf-2026-10-11", "retrieved_at": "2026-10-11T19:11:28Z", "content_hash": "e7111969908bbf588c20b457b6f5f26ce16e6d9e023e7e179d8a9c1b54a318a0", "source_effective_date": null, "public_archive_url": null, "source_state": "current" } ] }, { "id": "cardio:who-sodium-2012", "source_type": "guideline", "title": "Guideline: Sodium intake for adults and children", "canonical_url": "https://www.who.int/publications/i/item/9789241504836", "identifier_namespace": "isbn", "identifier_value": "978 92 4 150483 6", "publication_date": null, "publisher": "World Health Organization", "edition": "English PDF from WHO IRIS, fetched 2026-10-11. The copyright page reads 2012, reprinted 2014.", "reuse_basis": "All rights reserved, per the copyright page. Public text is cite_only: the copyright page says all rights reserved, so the terms do not clearly allow quotation (your WHO decision on issue 2 covers the CC BY-NC-SA guidelines). Easy to change to quote if you decide otherwise. 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Source: National Library of Medicine. This copy was fetched on 2026-10-11 and may not reflect the most current data. The raw bytes are committed at research/snapshots/cc-mesh-D017673.json.", "public_text": "quote", "snapshots": [ { "id": "cardio:mesh-d017673-2026-10-11", "retrieved_at": "2026-10-11T19:14:16Z", "content_hash": "f79dd6086cbda78a8aae4f0d7c46bbd13e2eaa8063991a3933c6c0e65cebf53a", "source_effective_date": "2018-07-02", "public_archive_url": null, "source_state": "current" } ] } ], "decisions": [ { "type": "recommendation", "id": "cardio:rec-nice-ng136-1-2-3", "direction": "for", "intervention_id": "cardio:ambulatory-bp-monitoring", "context_id": "cardio:ctx-nice-adults-suspected-hypertension", "guideline_snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "issuer_id": "cardio:nice", "jurisdiction": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. 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The recommendation is tagged with 2019, and the page shows a last update of 26 February 2026.", "superseded_by": null, "supersession_status": null, "claim_id": "cardio:claim-nice-ng136-1-2-3" }, { "type": "recommendation", "id": "cardio:rec-nice-ng136-1-2-4", "direction": "for", "intervention_id": "core:home-bp-monitoring", "context_id": "cardio:ctx-nice-adults-suspected-hypertension", "guideline_snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "issuer_id": "cardio:nice", "jurisdiction": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.", "strength_label": "Not labeled on the fetched page. The recommendation uses the verb offer.", "strength_system": "NICE wording convention. 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The page shows a last update of 26 February 2026.", "superseded_by": null, "supersession_status": null, "claim_id": "cardio:claim-nice-ng136-target-under-80" }, { "type": "recommendation", "id": "cardio:rec-nice-ng136-1-4-5", "direction": "against", "intervention_id": "cardio:salt-substitution", "context_id": "cardio:ctx-nice-ng136-adults-hypertension-potassium-substitute-groups", "guideline_snapshot_id": "cardio:nice-ng136-recs-2026-10-09", "issuer_id": "cardio:nice", "jurisdiction": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.", "strength_label": "Not labeled on the fetched page. The caution uses the wording should not be used.", "strength_system": "Not stated on the fetched NG136 page. The caution is imperative wording with no NICE strength label, and how NICE treats this wording was not verified.", "effective_date": "2019-08-28", "effective_date_note": "The date NG136 was first published. Recommendation 1.4.5 is tagged [2004, amended 2019], so it predates the guideline publication date. The page shows a last update of 26 February 2026.", "superseded_by": null, "supersession_status": null, "claim_id": "cardio:claim-nice-ng136-1-4-5-salt-caution" }, { "type": "recommendation", "id": "cardio:rec-who-2021-r1a", "direction": "for", "intervention_id": "cardio:bp-lowering-medicine", "context_id": "cardio:ctx-who-2021-adults-confirmed-hypertension", "guideline_snapshot_id": "cardio:who-9789240033986-eng-pdf-2026-10-11", "issuer_id": "cardio:who", "jurisdiction": "Global WHO guidance; national adoption not recorded", "strength_label": "Strong recommendation, moderate- to high-certainty evidence", "strength_system": "GRADE. 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Section 2.5 of the WHO guideline (PDF page 17) says the guideline development group rated the certainty of evidence and developed the recommendations with the GRADE approach, and it defines a strong recommendation and a weak or conditional one.", "effective_date": "2021-08-24", "effective_date_note": "The publication date on the WHO publication page.", "superseded_by": null, "supersession_status": "not_checked", "claim_id": "cardio:claim-who-2021-r8" }, { "type": "recommendation", "id": "cardio:rec-who-2025-lsss", "direction": "for", "intervention_id": "cardio:salt-substitution", "context_id": "cardio:ctx-who-2025-adults-general-population", "guideline_snapshot_id": "cardio:who-lsss-pdf-2026-10-11", "issuer_id": "cardio:who", "jurisdiction": "Not tied to one country: a WHO global guideline. The document states no legal jurisdiction.", "strength_label": "Conditional recommendation", "strength_system": "WHO guideline process with GRADE: strong or conditional. A conditional recommendation is one where the group is less certain that the desirable consequences outweigh the undesirable ones (footnote 6 of the executive summary). WHO describes the evidence as \"moderate-to-low certainty (an assessment of low certainty overall ...)\"; the atlas records low.", "effective_date": "2025-01-27", "effective_date_note": "Publication date shown on the WHO page. 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