Magnitude of the early morning blood pressure surge in hypertensive patients
Bibliographic record
Abstract
To assess the prevalence and magnitude of the early morning blood pressure surge in hypertensives without significant co-morbidities. The diurnal rhythm of blood pressure and the early morning blood pressure surge (EMBPS) are powerful risk factors for cardiovascular events, independently of office blood pressure. We used baseline data from two large, randomized comparative studies of 1358 mild-to-moderate hypertensives (seated DBP 95–109 mmHg, 24-h mean DBP ≥85 mmHg). Patients had no hepatic or renal impairment, congestive heart failure, or uncontrolled type 2 diabetes (HbA1C ≥10%). Blood pressure was assessed using 24-h ambulatory blood pressure monitoring, and times of sleep and waking were recorded by patient diary. We calculated blood pressure for the following periods: sleeping mean, awake mean, night-time low (NTL), early morning mean (EMM) and EMBPS (EMM – NTL). 24-h mean±SD ambulatory SBP/DBP was 148±12/93±6 mmHg, and mean ambulatory awake SBP/DBP was 154±12/97±7 mmHg. The mean duration of sleep was 7.7±1.2 hours, with mean SBP/DBP 136±14/82±8 mmHg and a NTL of 124±14/73±9 mmHg. The EMM was 150±15/96±9 mmHg, giving a mean EMBPS of 26±13/23±10 mmHg. Half of the patients had a systolic EMBPS ≥25 mmHg. These data show that, in these hypertensive patients with good glycemic control and no renal impairment, a normal diurnal rhythm of blood pressure was apparent but a high EMBPS was common.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| 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".