A comparison of the efficacy and duration of action of telmisartan, amlodipine and ramipril in patients with confirmed ambulatory hypertension
Bibliographic record
Abstract
OBJECTIVES: The aim of the study was to compare the antihypertensive effects and the duration of action of telmisartan, amlodipine and ramipril in patients with mild-to-moderate hypertension using ambulatory blood pressure (ABP) monitoring. METHODS: After a 2-4-week single-blind, placebo run-in period, qualifying patients were randomized to receive telmisartan 80 mg (n=18); amlodipine 5 mg (n=22); titrated to 10 mg after 4 weeks; or ramipril 2.5 mg (n=17); titrated to 5 mg and 10 mg after 1 and 3 weeks, respectively, administered once daily in the morning (0700 h). Ambulatory blood pressure monitoring was performed at baseline and at the end of the 8-week treatment period. Plasma renin activity was measured over 24 h at the same time points. RESULTS: Telmisartan and amlodipine provided significant reductions from baseline (P<0.0001) and not statistically different reductions between treatments in ABP during daytime (9.3/6.0 and 14.7/9.4 mmHg, respectively) and night-time (12.4/7.7 and 13.3/8.6 mmHg, respectively) at the end of 8 weeks' treatment. In contrast, although ramipril provided significant reductions in ambulatory systolic and diastolic BP from 2-6 h post dose (peak effect), it failed to induce significant reductions in mean daytime (4.5/1.6 mmHg) and night-time (1.8/0.1 mmHg) ambulatory BP. In addition, the greater reductions in ABP with telmisartan and amlodipine were associated with a significant rise in plasma renin activity whereas ramipril only increased renin during the first 4 h of the administration interval. CONCLUSION: The results of the present study confirm the efficacy of both telmisartan and amlodipine in reducing ABP during each period of the 24-h interval. Because ABP reduction with ramipril was restricted to its peak effect, the present data do not support the use of this agent when administered once daily in the morning.
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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 | 0.002 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".