Reaching the therapeutic goal in hypertension: results from the Canadian valsartan observational study. (Diovantage 4).
Bibliographic record
Abstract
BACKGROUND: Hypertension is a leading cause of death worldwide, and a major public health problem in Canada. Despite treatment guidelines and availability of therapies for blood pressure (BP) management, treatment of hypertension remains sub-optimal. OBJECTIVES: The objectives of this trial are to observe BP reduction, compliance and regimen changes 3 months after initiation of valsartan alone or with hydrochlorothiazide and optimized patient support. METHODS: As of February 2007, 34,033 patients with essential hypertension and prescribed valsartan alone or with hydrochlorothiazide for BP management were enrolled across 2,125 Canadian sites. Patients were newly diagnosed (38%), switched from another anti-hypertensive agent (38%) or received valsartan with or without hydrochlorothiazide as added therapy (20%). All patients were offered a home blood pressure monitor, access to nursing support and educational materials. Patients were assessed after 3 months for compliance, therapeutic response, and need for treatment modifications. RESULTS: In this interim analysis, after 3 months of treatment, 95% of patients reported being compliant with therapy and 59% achieved target BP (<140/90 mmHg). In the evaluable population (n=15,200), significant reductions in mean systolic (-18.5+/-19.3 mm/Hg, p<0.0001) and diastolic (-9.4+/-11.2 mmHg; p<0.0001) BP were observed. For patients not reaching target BP goals, no change in treatment was instituted in 55% of cases. CONCLUSIONS: This observational study demonstrates the benefits of valsartan alone or with hydrochlorothiazide and optimized patient support in BP management of patients with essential hypertension. Interestingly, no modification to the anti-hypertensive regimen was done in 55% of patients not having reached treatment goals.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".