Amlodipine or lisinopril was not better than chlorthalidone in lowering CHD risk in hypertension
Bibliographic record
Abstract
LetterNovember 1, 2003Amlodipine or lisinopril was not better than chlorthalidone in lowering CHD risk in hypertensionGeorge A. Heckman, MD, FRCPC, Heart and Stroke FellowGeorge A. Heckman, MD, FRCPC, Heart and Stroke FellowGeriatrics and Internal Medicine, McMaster University, Hamilton, Ontario, Canada (G.A.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2003-139-3-A15 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail To the EditorAlthough not mentioned by Dr. Psaty in his commentary (1), concerns have been raised over the heart failure results in ALLHAT (2). Asymptomatic left ventricular (LV) systolic dysfunction is common in older patients, particularly men and patients with cardiovascular risk factors (3, 4). ALLHAT participants were high-risk patients, and many may have had asymptomatic LV dysfunction that could have been unmasked at the start of the study by withdrawal of diuretic therapy. The early difference in heart failure (HF) incidence observed between the lisinopril and chlorthalidone groups, as well as the merging of the HF curves toward the ...References1 Psaty BM.Amlodipine or lisinopril was not better than chlorthalidone in lowering CHD risk in hypertension [Comment]. ACP J Club. 2003;139:7. [PMID: 12841711] Google Scholar2 Williams B. Drug treatment of hypertension: implications of ALLHAT. Heart. 2003;89:589-90. [PMID: 12748205] Google Scholar3 Morgan S, Smith H, Simpson I, et al. Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey. BMJ. 1999;318:368-72. [PMID: 9933201] Google Scholar4 Davis RC, Hobbs FD, Kenkre JE, et al. Prevalence of left ventricular systolic dysfunction and heart failure in high risk patients: community based epidemiological study. BMJ. 2002;325:1156. [PMID: 12433768] Google Scholar5 ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981-97. [PMID: 12479763] Google Scholar6 Hansson L, Lindholm LH, Ekbom T, et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet. 1999;354:1751-6. [PMID: 10577635] Google Scholar7 Wing LM, Reid CM, Ryan P, et al. A comparison of outcomes with angiotensin-converting–enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. 2003;348:583-92. [PMID: 12584366] Google Scholar8 Gibbs CR, Beevers DG, Lip GY. The management of hypertensive disease in black patients. QJM. 1999;92:187-92. [PMID: 10396605] Google Scholar9 Kuller L, Borhani N, Furberg C, et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol. 1994;139:1164-79. [PMID: 8209875] Google Scholar10 Kitzman DW, Gardin JM, Gottdiener JS, et al. Importance of heart failure with preserved systolic function in patients > or = 65 years of age. CHS Research Group. Cardiovascular Health Study. Am J Cardiol. 2001;87:413-9. [PMID: 11179524] Google Scholar11 Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995;273:408-12. [PMID: 7823387] Google Scholar Author, Article, and Disclosure InformationAffiliations: Geriatrics and Internal Medicine, McMaster University, Hamilton, Ontario, Canada (G.A.H.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails November 1, 2003Volume 139, Issue 3Page: A15KeywordsACE inhibitorsCardiovascular diseasesCoronary heart diseaseDiureticsEchocardiographyEjection fractionElderlyEnzymesEpidemiologyHeart failureHospitalizationsHypertensionMedical risk factorsMyocardial infarctionPrevention, policy, and public healthRisk managementSexual identity ePublished: 9 March 2020 Issue Published: November 1, 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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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 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.003 |
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".