Abstract 265: Morning Dosing of Eplerenone Improves Daytime Blood Pressure Control but Not Fibrinolytic Balance
Bibliographic record
Abstract
The renin angiotensin-aldosterone system has a diurnal variation, proceeding morning increases in blood pressure and plasminogen activator inhibitor-1 (PAI-1) levels. The RAAS is particularly active in individuals with metabolic syndrome (MetS) resulting in increased blood pressure and elevated PAI-1 levels. Eplerenone is a mineralocorticoid antagonist that is approved for the treatment of hypertension with a half-life of 4-6 hours but can be prescribed once or twice daily. This is a double-blind crossover study that examines the effects of morning (AM) vs. nighttime (PM) administration of eplerenone on blood pressure, PAI-1, plasma renin activity (PRA), and plasma aldosterone levels. Twenty subjects with MetS were studied on three 24-hour inpatient study days on hydrochlorothiazide (25mg) alone and with concomitant morning or evening dosing of eplerenone (100mg). Vital signes were taken and blood was drawn every three hours. There was a statistically significant increase in aldosterone levels with both AM (266±21 ng/dL) and PM (320±31 ng/dL) dosing of eplerenone compared to baseline (194±11 ng/dL) (both p < 0.001) with no significant difference between the two dosing strategies. There was a trend suggesting a daytime (8AM-5PM) systolic blood pressure reduction of 4.9±1.4 mmHg (p = 0.06) with AM dosing. Furthermore, diastolic blood pressure appeared less volatile with AM dosing (range = 38 mmHg vs. 47 mmHg for baseline and PM). There was no difference between baseline, AM and PM dosing with regard to PRA, PAI-1, serum potassium or creatinine. These findings suggest that there may be improved overall control of blood pressure with AM dosing of eplerenone, without obvious deleterious effects such as elevated creatinine or potassium levels. Furthermore, increases in aldosterone did not result in increases in PAI-1. Consequently rational dosing strategies such as this merit further investigation.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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 | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".