Effects of telmisartan, ramipril and amlodipine on circadian blood pressure, heart rate and norepinephrine cycles in essential hypertensive patients
Bibliographic record
Abstract
The objective of this trial was to study the effect of chronic treatments with telmisartan (TELMI), ramipril (RAM) and amlodipine (AMLO) on the circadian rhythm of blood pressure (BP), heart rate (HR) and circulating norepinephrine (NE) levels in mild to moderate essential hypertension. Fifty-seven essential hypertensive patients were incorporated in a randomized parallel design study after a 2 to 4 week placebo run-in period. Patients with diastolic BP greater or equal to 95 mmHg and less or equal to110 mmHg were randomized in a double blind fashion to either TELMI 80 mg qd for 8 weeks, or AMLO (5 mg for 4 weeks followed by 10 mg for 4 weeks) or RAM 2.5 mg for 1 week, 5.0 mg for 3 weeks and 10 mg for the following 4 weeks. Patients were hospitalized for the last 24 hours of placebo treatment and for the last 24 hours of active treatment to have their BP, HR and NE levels measured every 4 hours and hourly for the last 4 hours (from 4:00 to 8:00 A.M.) in the supine position followed by a study in the standing position for 10 min. NE levels were measured with HPLC technique and BP and HR were measured respectively with ambulatory BP or HR monitoring devices. Circadian cycles were found for all 3 parameters. Systolic and diastolic BP were highest around 8:00 A.M. whereas HR tended to be highest around 8:00 P.M. and NE levels around noon, under placebo treatment. Both AMLO and TELMI reduced significantly systolic and diastolic BP but the fall in BP was highest with AMLO. No changes were observed in NE levels with TELMI or RAM but a 50% increase in NE levels was found in AMLO treated patients. The various treatments did not altered the pattern of the circadian rhythm but both RAM and TELMI tended to attenuate the variations in NE levels. The NE responses to standing increased in AMLO treated patients. Chronic therapies with AMLO and TELMI both lowered significantly BP for 24 hours, but not RAM. TELMI did not activate the sympathetic system, despite a significant reduction in blood pressure, whereas AMLO did increase supine NE levels all through the day and potentiated the NE response to standing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".