Comparison of a fixed-dose combination of telmisartan 40 mg + hydrochlorothiazide 12.5 mg with telmisartan 40 mg in the control of mild-to-moderate hypertension
Bibliographic record
Abstract
Optimizing treatment of hypertension may require the use of two or more drugs with different modes of action. This study was performed to assess whether a fixed-dose combination (FDC) of the angiotensin II antagonist telmisartan (T) 40 mg combined with the diuretic hydrochlorothiazide (HCTZ) 12.5 mg was superior to T 40 mg in patients with mild-to-moderate hypertension (mean seated DBP 95-114 mmHg, SBP 140-200 mmHg) who failed to respond adequately to T 40 mg monotherapy. After 4 weeks of open-label T 40 mg treatment, 146/473 (30.9%) patients who responded to therapy (i.e., seated DBP <90 mmHg) were excluded. Non-responding patients (n=327) were randomized to receive double-blind treatment with the FDC (n=160) or T 40 mg (n=167) for 8 weeks. Seated DBP and SBP were recorded after 4 and 8 weeks of treatment. After 8 weeks of treatment, FDC lowered DBP by an additional 3.5 mmHg (p<0.01) and SBP by 7.4 mmHg (p<0.01) compared with T 40 mg. Most of the additional effect of the FDC was seen after 4 weeks of treatment. At week 8, a normalized BP response (SBP <140 mmHg and DBP <90 mmHg) occurred in 51.6% of FDC-treated patients vs 23.5% of those treated with T 40 mg (p<0.05). The FDC normalized DBP in 64.8% of patients, whereas T 40 mg normalized DBP in 40.1% (p<0.05). Compared with baseline, SBP was reduced by ≥10 mmHg in 63.5% of patients receiving the FDC versus 42.6% of those treated with T 40 mg (p<0.05). Overall, both the FDC and T 40 mg were very well tolerated. Adverse events were predominantly mild in intensity, transient in nature, and considered unrelated to therapy. We can conclude from these findings that treatment with a FDC of T 40 mg + HCTZ 12.5 mg is clinically and statistically superior to T 40 mg in mild-to-moderate hypertensive patients failing to respond to T 40 mg monotherapy.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".