PERINDOPRIL IS EFFECTIVE TO SIGNIFICANTLY LOWER BLOOD PRESSURE IN HYPERTENSIVE PATIENTS UNTREATED OR UNCONTROLLED ON PREVIOUS TREATMENTS: FINDINGS OF THE CONFIDENCE TRIAL: PP.27.72
Bibliographic record
Abstract
Aims: To assess the blood pressure (BP) lowering efficacy of perindopril 4 to 8 mg/day (equivalent to perindopril arginine 5 to 10 mg/day) in patients whose hypertension was untreated or uncontrolled despite treatment with other antihypertensive drugs. Patients and Methods: This is an open-label, multicenter, observational trial conducted in Canadian general practice clinics. Patients (n = 8208; age: 59 ± 13.1 years) with uncontrolled hypertension (i.e. seated BP above 140/90 mm Hg or 130/80 mm Hg in the presence of diabetes, renal disease, or proteinuria) were prescribed perindopril 4 mg/day. Patients who were previously receiving other ACE inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) were switched to perindopril 4 mg/day. At visit 2 (after 14 to 28 days), dosage of perindopril could be increased to 8 mg/day in cases of failure to achieve BP control. Follow-up was over 12 weeks. Results: Perindopril significantly reduces BP among the overall population and the different subgroups as summarized in the table below. One third of patients required uptitration to the high dosage for higher normalization rate. Uptitration to 8 mg provided an additional mean 10.1/5.3 mm Hg BP reduction, which was even greater among severely hypertensive patients (15.1/5.7 mm Hg). Switching previous ACE inhibitor or ARB to perindopril resulted in reduced BP by a further 15.5/7.7 and 15.9/8.2 mm Hg, respectively. Perindopril was well tolerated, including when it replaced treatment with other ACEIs or ARBs. Conclusions: This trial demonstrates that a perindopril-based strategy uptitrated to the maximal dose as required for BP control, significantly reduces SBP and DBP in untreated or uncontrolled hypertensive patients irrespective of their previous treatment. These findings, combined with its proven risk reduction in myocardial infarction, stroke, and death, make perindopril an optimal treatment for a wide range of hypertensive patients.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".