S-16-1: RESISTANT HYPERTENISION: CLINICAL CHARACTERISTICS AND BLOOD PRESSURE CONTROL
Bibliographic record
Abstract
Objectives: We quantified the characteristics of patients with treatment resistant hypertension (TRH) in a large multi-country sample of specialist tertiary centres and estimated incidence and prevalence in participating regions. Methods: The Survey of Patients with treatment Resistant hyperTension (SPIRIT) study was a retrospective review of medical records of patients seen at tertiary centres located in Western Europe, Eastern Europe, North America, South America, Australia and Asia. Data on demographics, medical history and medication use were extracted from medical records. Prevalence and incidence of TRH were estimated based upon reported catchment populations. Results: 1555 patients from 76 centres in 15 countries were included from May-August 2017. Mean age was 64 (SD, 12.7), 60% were males and 62% were Caucasian, 36% had CKD (eGFR < 60 ml/min), 41% had diabetes, 12% were smokers and 27% had a previous CV event. Daytime ambulatory BP was the most frequently used measurement (46%) with a mean systolic BP of 144 mmHg (SD, 19.2) and diastolic BP 81 mmHg (SD, 13.8). 95% patients were prescribed diuretics (thiazides 75%), 93% an inhibitor of the renin-angiotensin aldosterone system, 86% a calcium antagonist, 75% a beta-blocker and 35% an aldosterone antagonist. There were moderate differences in participant characteristics and management patterns between regions. The overall estimated mean incidence of TRH was 5.8 per 100,000 per year (ranging between 2.3 and 14.0 across regions) and the corresponding estimated mean prevalence of TRH was 23.9 per 100,000, ranging between 7.6 and 90.5 across regions. Conclusion: TRH remains a common health issue. Observed variation between regions likely reflects some real differences in patient characteristics and physician management practices, but may also be due to inconsistent patient recruitment methods across participating centres.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".