Abstract 104: First Stroke Reduced 44 Percent by Well Tolerated Medications. Stroke Outcomes From the Heart Outcomes Prevention Evaluation 3 Study
Bibliographic record
Abstract
Background: Most (75%) strokes are first strokes, and primary prevention is crucial for reducing the global burden of stroke The role of fixed-dose antihypertensive therapy and statin drugs for primary stroke prevention has not been adequately defined. Methods: Using a 2x2 factorial design, 12,705 participants from 21 countries with an intermediate risk of cardiovascular disease but without overt vascular disease were randomized to fixed-dose candesartan 16 mg plus hydrochlorothiazide (HCTZ) 12.5 mg daily or placebo and to rosuvastatin 10mg daily or placebo. Results: Mean age was 66 years, 46% were women, and 166 strokes occurred during a median follow-up of 5.6 years. Mean baseline blood pressure (BP) was 138/82 mmHg and the BP difference between the treatment groups during follow-up averaged 6.0/3.0 mmHg. Stroke was reduced by 20% (confidence interval [CI], 0.59-1.08; p =0.14) by candesartan/HCTZ and 30% (CI, 0.52-0.95) by rosuvastatin. In a pre-specified subgroup analysis, participants in the upper third of systolic BP (>143.5 mmHg) had stroke reduced by 42% (CI, 0.37-0.90, p =0.02). Rosuvatatin reduced all stroke by 30% (CI, 0.52-0.95; p =0.02); but considering hemorrhagic strokes: 15 among those assigned rosuvastatin vs. 12 with rosuvastatin-placebo. Those assigned both rosuvatatin and candesartan/HCTZ had stroke reduced by 44% ( CI, 0.36-0.87; p =0.009). Rates of permanent discontinuation did not differ significantly between active and placebo-assigned patients. Conclusions: Fixed-dose candesartan/HCTZ combined with low-dose rosuvastatin reduced first stroke by 44% in patients at intermediate risk of cardiovascular disease and was well-tolerated. Among those with systolic BP >143.5 mmHg, fixed-dose candesartan/HCTZ reduces first stroke by 42%,
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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 | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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".