human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study determined the effect of nonsteroidal anti-inflammatory drug ( NSAID ) administration on blood pressure in hypertensive patients taking hydrochlorothiazide ( HCTZ ) . Ninety-seven patients with mild essential hypertension and a musculoskeletal indication for NSAID use were studied in a three-phase , multi-center , double-blind , r and omized , parallel study based in 15 academic and community clinics . Patients served as their own controls . Patients with stable hypertension , not taking antihypertensive or NSAID medications , were treated with HCTZ 50 mg/day . After 4 to 5 weeks of treatment and documented stable blood pressure , naproxen 375 mg twice a day or ibuprofen 800 mg three times a day was added . Blood pressure was measured at 2 and 4 weeks of NSAID therapy . The average diastolic blood pressure was 97.5 + /- 2.4 mm Hg and the average of the mean arterial pressure ( MAP ) was 116.8 + /- 6.04 before treatment with HCTZ . Hydrochlorothiazide treatment decreased diastolic blood pressure to 83.1 + /- 5.6 mm Hg , and MAP to 101.1 + /- 6.5 mm Hg . With naproxen or ibuprofen treatments , mean diastolic blood pressure increased less than 3 mm Hg . At 2 weeks , ibuprofen increased diastolic blood pressure by 2.6 mm Hg ( P = .004 ) and naproxen increased diastolic blood pressure 0.7 mm Hg ( P = .40 ) . Both ibuprofen and naproxen significantly increased diastolic pressure at 4 weeks ( 2.1 mm Hg , P = .042 ; and 1.8 mm Hg , P = .043 , respectively ) . There was no correlation between the pre-NSAID blood pressure and the magnitude of change after 2 or 4 weeks of treatment . Changes in MAP reflected a pattern similar to diastolic pressure . ( ABSTRACT TRUNCATED AT 250 WORDS The value of anticoagulant therapy after acute myocardial infa rct ion has been assessed in 1,136 patients admitted to the Bronx Municipal Hospital Center . The treatment reduced the overall mortality in women from 31 % to 15 % , particularly those 55 years of age or over , with moderately severe infa rct ion . The low overall mortality in control men ( 16 % ) was not reduced with treatment , though there was significant reduction of the mortality in a subgroup of men with moderately severe infa rct ion showing Q-wave evolution . Age and sex , as well as the severity of the episode of acute myocardial infa rct ion , are important in determining whether anticoagulant therapy is likely to be beneficial Background The clinical usefulness of intravenous thrombolytic therapy in unstable angina is currently unknown , despite the pathogenetic similarity of this entity to acute myocardial infa rct ion , for which thrombolysis has enjoyed great success . To compare the clinical benefit of intravenous urokinase with that of conventional antithrombotic therapy in preventing the progression of unstable angina to new myocardial infa rct ion , intractable angina , or death within the first 96 hours after hospitalization , 149 patients with unstable angina were r and omized to one of two intravenous thrombolytic strategies . Methods and Results Forty-nine patients received 3 million units urokinase i.v . over 90 minutes plus intravenous heparin ( group A ) ; 47 patients received unblinded 3 million units urokinase i.v . plus 325 mg aspirin p.o . daily ( group B ) ; and 53 patients received placebo thrombolytic infusion plus full-dose heparin ( group C ) . The primary end point of this trial was 96-hour clinical status . There were no significant differences in the baseline characteristics ( age , sex , previous myocardial infa rct ion , hypertension prevalence , diabetes , tobacco use , or previous revascularization ) among the three groups . Despite an excess of minor untoward reactions for the urokinase groups ( chills , 26.5 % and 23.4 % for groups A and B versus 0 % for group C ; p<0.01 ) , there was no significant difference with respect to major bleeds ( two , none , and two for groups A , B , and C , respectively;p = NS ) . At 96 hours after presentation , no significant difference emerged in the incidence of new cardiac events : new myocardial infa rct ions developed in 10.2 % of group A , 6.4 % of group B , and 3.8 % of group C ( p = NS ) ; intractable angina occurred in 6.1 % of group A , 10.6 % of group B , and 9.4 % of group C ( p = NS ) . There were no deaths . All three groups encountered a similar incidence of overall cardiac events : 16.31 % , 17.0 % , and 13.2 % for groups A , B , and C , respectively ( p = NS ) . Although trial enrollment was to extend to 600 patients , interim analysis led to early cessation of enrollment due to a negative trend in respect to outcome after thrombolysis . Conclusions High-dose intravenous urokinase followed by either heparin or aspirin can be safely administered to a broad , unselected group of patients with unstable angina . However , this study suggests that no clinical advantage is conferred by urokinase , with either adjunctive antithrombotic therapy over st and ard heparin therapy alone , when given relatively late ( mean , 8.7 hours ) after admission for unstable angina . A possible detrimental effect can not be excluded AIMS To assess the effect of tr and olapril ( 2 mg once daily ) and indomethacin ( 25 mg three times daily ) , alone and in combination , on renal function and renal functional reserve in hypertensive patients ( DBP 95 - 115 mmHg ) requiring regular non-steroidal anti-inflammatory drugs ( NSAIDs ) . METHODS R and omized , double-blind , placebo-controlled , four way crossover design . After 3 weeks treatment renal plasma flow ( RPF ) and glomerular filtration rate ( GFR ) were measured using the p-aminohippurate ( PAH ) and inulin methods . Renal functional reserve was estimated by measuring RPF and GFR at the end of an intravenous infusion of dopamine 2 microg kg(-1 ) and 10 % amino acid solution . RESULTS There was no significant difference in RPF between treatments : -22.79 ml min(-1 ) ( 95 % CI -54.82 , 9.24 ) for placebo and tr and olapril , -10.37 ml min(-1 ) ( 95 % CI -30.7 , 9.96 ) for placebo and indomethacin , -14.78 ml min(-1 ) ( 95 % CI -50.33 , 20.77 ) for placebo and tr and olapril with indomethacin . There was no significant difference in functional reserve RPF between treatments : -34.96 ml min(-1 ) ( 95 % CI -119.8 , 49.88 ) for placebo and tr and olapril , 29.78 ml min(-1 ) , -15.18 , 74.74 ) for placebo and indomethacin , and -25.84 ml min(-1 ) ( 95 % CI -87.62 , 35.94 ) for placebo and tr and olapril with indomethacin . There was no significant difference in GFR between treatments : -1.01 ml min(-1 ) ( 95 % CI -7.45 , 5.42 ) for placebo and tr and olapril , -7.88 ml min(-1 ) ( 95 % CI -15.08 , -0.68 ) for placebo and indomethacin , and -0.36 ml min(-1 ) ( 95 % CI -7.58 , 6.86 ) for placebo and tr and olapril with indomethacin . There was no significant difference in functional reserve GFR between treatments : 5.13 ml min(-1 ) ( 95 % CI -4.97 , 15.23 ) for placebo and tr and olapril , 6.31 ml min(-1 ) ( 95 % CI -1.88 , 14.5 ) for placebo and indomethacin , 7.21 ml min(-1 ) ( 95 % CI 1.26 , 13.16 ) for placebo and tr and olapril with indomethacin . CONCLUSION In hypertensives chronic treatment with NSAIDs or ACEI alone or in combination did not change RPF or GFR and did not change renal functional reserve capacity of RPF or GFR BACKGROUND AND PURPOSE From a physiological perspective , physical activity might be expected to decrease the risk of developing stroke . However , epidemiological studies of physical activity and stroke risk have yielded divergent findings . We therefore sought to examine the association between exercise and stroke risk . METHODS This was a prospect i ve cohort study of 21 823 men , followed up for an average of 11.1 years . Participants were from the Physicians ' Health Study , a r and omized trial of low-dose aspirin and beta carotene . Men , aged 40 to 84 years at baseline , were free of self-reported myocardial infa rct ion , stroke , transient ischemic attack , and cancer . At baseline , they reported on the frequency of exercise vigorous enough to work up a sweat . Stroke occurrence was reported by participants and confirmed after medical record review ( n=533 ) . We used Cox proportional hazards regression to analyze the data . RESULTS With adjustment for age , treatment assignment , smoking , alcohol intake , history of angina , and parental history of myocardial infa rct ion , the relative risks of total stroke associated with vigorous exercise < 1 time , 1 time , 2 to 4 times , and > /=5 times per week at baseline were 1.00 ( referent ) , 0.79 ( 95 % confidence interval [ CI ] , 0.61 to 1 . 03 ) , 0.80 ( 95 % CI , 0.65 to 0.99 ) , and 0.79 ( 95 % CI , 0.61 to 1.03 ) , respectively ; P for trend=0.04 . In subgroup analyses , the inverse association appeared stronger with hemorrhagic than ischemic stroke . When we additionally adjusted for body mass index , history of hypertension , high cholesterol , and diabetes mellitus , corresponding relative risks for total stroke were 1.00 ( referent ) , 0.81 ( 95 % CI , 0.61 to 1.07 ) , 0.88 ( 95 % CI , 0.70 to 1.10 ) , and 0.86 ( 95 % CI , 0.65 to 1.13 ) , respectively ; P for trend=0.25 . CONCLUSIONS Exercise vigorous enough to work up a sweat is associated with decreased  stroke risk in men . In the present study , the inverse association with physical activity appeared to be mediated through beneficial effects on body weight , blood pressure , serum cholesterol , and glucose tolerance . Apart from its favorable influences on these variables , physical activity had no significant residual association with stroke incidence To evaluate the influence of salt sensitivity on the blood pressure response to oral indomethacin treatment , we studied 35 hospitalized essential hypertensive patients ( 24 men and 11 women , aged from 40 to 55 years ) . During a normal NaCl intake ( 120 mmol Na+ per day ) , patients were assigned to receive in a r and omized double-blind fashion either 200 mg indomethacin ( 25 patients ) or placebo ( 10 patients ) for 5 days . Two weeks after the interruption of indomethacin treatment , during which the normal NaCl intake was continued , salt sensitivity was assessed by giving each patient a high ( 220 mmol Na+ per day for 10 days ) and then a low ( 20 mmol Na+ per day for 10 days ) NaCl diet . Blood pressure changes were evaluated , and the measurement taken at the end of the 2 weeks under normal sodium intake was considered baseline blood pressure . Patients were classified as salt sensitive when a diastolic blood pressure change of 10 mm Hg or more occurred after both low and high periods of sodium intake . In salt-resistant patients treated with indomethacin ( n = 12 , nine men and three women , mean age 50.5 + /- 3.7 years ) , neither blood pressure ( systolic blood pressure from 150.8 + /- 11.2 to 154.6 + /- 9.3 mm Hg , NS ; diastolic blood pressure from 99.3 + /- 2.1 to 101.1 + /- 4.4 mm Hg , NS ) nor the urinary Na+ excretion ( from 108.1 + /- 20.9 to 97.9 + /- 9.1 mmol/24 hr , NS ) was significantly affected by the drug . ( ABSTRACT TRUNCATED AT 250 WORDS Twenty four male hypertensive patients suffering also from peripheral obstructive arterial disease were r and omly subdivided in two groups and after a period of farmacological wash-out of one month Group I was 
    Output:
    
agent
Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study determined the effect of nonsteroidal anti-inflammatory drug ( NSAID ) administration on blood pressure in hypertensive patients taking hydrochlorothiazide ( HCTZ ) . Ninety-seven patients with mild essential hypertension and a musculoskeletal indication for NSAID use were studied in a three-phase , multi-center , double-blind , r and omized , parallel study based in 15 academic and community clinics . Patients served as their own controls . Patients with stable hypertension , not taking antihypertensive or NSAID medications , were treated with HCTZ 50 mg/day . After 4 to 5 weeks of treatment and documented stable blood pressure , naproxen 375 mg twice a day or ibuprofen 800 mg three times a day was added . Blood pressure was measured at 2 and 4 weeks of NSAID therapy . The average diastolic blood pressure was 97.5 + /- 2.4 mm Hg and the average of the mean arterial pressure ( MAP ) was 116.8 + /- 6.04 before treatment with HCTZ . Hydrochlorothiazide treatment decreased diastolic blood pressure to 83.1 + /- 5.6 mm Hg , and MAP to 101.1 + /- 6.5 mm Hg . With naproxen or ibuprofen treatments , mean diastolic blood pressure increased less than 3 mm Hg . At 2 weeks , ibuprofen increased diastolic blood pressure by 2.6 mm Hg ( P = .004 ) and naproxen increased diastolic blood pressure 0.7 mm Hg ( P = .40 ) . Both ibuprofen and naproxen significantly increased diastolic pressure at 4 weeks ( 2.1 mm Hg , P = .042 ; and 1.8 mm Hg , P = .043 , respectively ) . There was no correlation between the pre-NSAID blood pressure and the magnitude of change after 2 or 4 weeks of treatment . Changes in MAP reflected a pattern similar to diastolic pressure . ( ABSTRACT TRUNCATED AT 250 WORDS The value of anticoagulant therapy after acute myocardial infa rct ion has been assessed in 1,136 patients admitted to the Bronx Municipal Hospital Center . The treatment reduced the overall mortality in women from 31 % to 15 % , particularly those 55 years of age or over , with moderately severe infa rct ion . The low overall mortality in control men ( 16 % ) was not reduced with treatment , though there was significant reduction of the mortality in a subgroup of men with moderately severe infa rct ion showing Q-wave evolution . Age and sex , as well as the severity of the episode of acute myocardial infa rct ion , are important in determining whether anticoagulant therapy is likely to be beneficial Background The clinical usefulness of intravenous thrombolytic therapy in unstable angina is currently unknown , despite the pathogenetic similarity of this entity to acute myocardial infa rct ion , for which thrombolysis has enjoyed great success . To compare the clinical benefit of intravenous urokinase with that of conventional antithrombotic therapy in preventing the progression of unstable angina to new myocardial infa rct ion , intractable angina , or death within the first 96 hours after hospitalization , 149 patients with unstable angina were r and omized to one of two intravenous thrombolytic strategies . Methods and Results Forty-nine patients received 3 million units urokinase i.v . over 90 minutes plus intravenous heparin ( group A ) ; 47 patients received unblinded 3 million units urokinase i.v . plus 325 mg aspirin p.o . daily ( group B ) ; and 53 patients received placebo thrombolytic infusion plus full-dose heparin ( group C ) . The primary end point of this trial was 96-hour clinical status . There were no significant differences in the baseline characteristics ( age , sex , previous myocardial infa rct ion , hypertension prevalence , diabetes , tobacco use , or previous revascularization ) among the three groups . Despite an excess of minor untoward reactions for the urokinase groups ( chills , 26.5 % and 23.4 % for groups A and B versus 0 % for group C ; p<0.01 ) , there was no significant difference with respect to major bleeds ( two , none , and two for groups A , B , and C , respectively;p = NS ) . At 96 hours after presentation , no significant difference emerged in the incidence of new cardiac events : new myocardial infa rct ions developed in 10.2 % of group A , 6.4 % of group B , and 3.8 % of group C ( p = NS ) ; intractable angina occurred in 6.1 % of group A , 10.6 % of group B , and 9.4 % of group C ( p = NS ) . There were no deaths . All three groups encountered a similar incidence of overall cardiac events : 16.31 % , 17.0 % , and 13.2 % for groups A , B , and C , respectively ( p = NS ) . Although trial enrollment was to extend to 600 patients , interim analysis led to early cessation of enrollment due to a negative trend in respect to outcome after thrombolysis . Conclusions High-dose intravenous urokinase followed by either heparin or aspirin can be safely administered to a broad , unselected group of patients with unstable angina . However , this study suggests that no clinical advantage is conferred by urokinase , with either adjunctive antithrombotic therapy over st and ard heparin therapy alone , when given relatively late ( mean , 8.7 hours ) after admission for unstable angina . A possible detrimental effect can not be excluded AIMS To assess the effect of tr and olapril ( 2 mg once daily ) and indomethacin ( 25 mg three times daily ) , alone and in combination , on renal function and renal functional reserve in hypertensive patients ( DBP 95 - 115 mmHg ) requiring regular non-steroidal anti-inflammatory drugs ( NSAIDs ) . METHODS R and omized , double-blind , placebo-controlled , four way crossover design . After 3 weeks treatment renal plasma flow ( RPF ) and glomerular filtration rate ( GFR ) were measured using the p-aminohippurate ( PAH ) and inulin methods . Renal functional reserve was estimated by measuring RPF and GFR at the end of an intravenous infusion of dopamine 2 microg kg(-1 ) and 10 % amino acid solution . RESULTS There was no significant difference in RPF between treatments : -22.79 ml min(-1 ) ( 95 % CI -54.82 , 9.24 ) for placebo and tr and olapril , -10.37 ml min(-1 ) ( 95 % CI -30.7 , 9.96 ) for placebo and indomethacin , -14.78 ml min(-1 ) ( 95 % CI -50.33 , 20.77 ) for placebo and tr and olapril with indomethacin . There was no significant difference in functional reserve RPF between treatments : -34.96 ml min(-1 ) ( 95 % CI -119.8 , 49.88 ) for placebo and tr and olapril , 29.78 ml min(-1 ) , -15.18 , 74.74 ) for placebo and indomethacin , and -25.84 ml min(-1 ) ( 95 % CI -87.62 , 35.94 ) for placebo and tr and olapril with indomethacin . There was no significant difference in GFR between treatments : -1.01 ml min(-1 ) ( 95 % CI -7.45 , 5.42 ) for placebo and tr and olapril , -7.88 ml min(-1 ) ( 95 % CI -15.08 , -0.68 ) for placebo and indomethacin , and -0.36 ml min(-1 ) ( 95 % CI -7.58 , 6.86 ) for placebo and tr and olapril with indomethacin . There was no significant difference in functional reserve GFR between treatments : 5.13 ml min(-1 ) ( 95 % CI -4.97 , 15.23 ) for placebo and tr and olapril , 6.31 ml min(-1 ) ( 95 % CI -1.88 , 14.5 ) for placebo and indomethacin , 7.21 ml min(-1 ) ( 95 % CI 1.26 , 13.16 ) for placebo and tr and olapril with indomethacin . CONCLUSION In hypertensives chronic treatment with NSAIDs or ACEI alone or in combination did not change RPF or GFR and did not change renal functional reserve capacity of RPF or GFR BACKGROUND AND PURPOSE From a physiological perspective , physical activity might be expected to decrease the risk of developing stroke . However , epidemiological studies of physical activity and stroke risk have yielded divergent findings . We therefore sought to examine the association between exercise and stroke risk . METHODS This was a prospect i ve cohort study of 21 823 men , followed up for an average of 11.1 years . Participants were from the Physicians ' Health Study , a r and omized trial of low-dose aspirin and beta carotene . Men , aged 40 to 84 years at baseline , were free of self-reported myocardial infa rct ion , stroke , transient ischemic attack , and cancer . At baseline , they reported on the frequency of exercise vigorous enough to work up a sweat . Stroke occurrence was reported by participants and confirmed after medical record review ( n=533 ) . We used Cox proportional hazards regression to analyze the data . RESULTS With adjustment for age , treatment assignment , smoking , alcohol intake , history of angina , and parental history of myocardial infa rct ion , the relative risks of total stroke associated with vigorous exercise < 1 time , 1 time , 2 to 4 times , and > /=5 times per week at baseline were 1.00 ( referent ) , 0.79 ( 95 % confidence interval [ CI ] , 0.61 to 1 . 03 ) , 0.80 ( 95 % CI , 0.65 to 0.99 ) , and 0.79 ( 95 % CI , 0.61 to 1.03 ) , respectively ; P for trend=0.04 . In subgroup analyses , the inverse association appeared stronger with hemorrhagic than ischemic stroke . When we additionally adjusted for body mass index , history of hypertension , high cholesterol , and diabetes mellitus , corresponding relative risks for total stroke were 1.00 ( referent ) , 0.81 ( 95 % CI , 0.61 to 1.07 ) , 0.88 ( 95 % CI , 0.70 to 1.10 ) , and 0.86 ( 95 % CI , 0.65 to 1.13 ) , respectively ; P for trend=0.25 . CONCLUSIONS Exercise vigorous enough to work up a sweat is associated with decreased  stroke risk in men . In the present study , the inverse association with physical activity appeared to be mediated through beneficial effects on body weight , blood pressure , serum cholesterol , and glucose tolerance . Apart from its favorable influences on these variables , physical activity had no significant residual association with stroke incidence To evaluate the influence of salt sensitivity on the blood pressure response to oral indomethacin treatment , we studied 35 hospitalized essential hypertensive patients ( 24 men and 11 women , aged from 40 to 55 years ) . During a normal NaCl intake ( 120 mmol Na+ per day ) , patients were assigned to receive in a r and omized double-blind fashion either 200 mg indomethacin ( 25 patients ) or placebo ( 10 patients ) for 5 days . Two weeks after the interruption of indomethacin treatment , during which the normal NaCl intake was continued , salt sensitivity was assessed by giving each patient a high ( 220 mmol Na+ per day for 10 days ) and then a low ( 20 mmol Na+ per day for 10 days ) NaCl diet . Blood pressure changes were evaluated , and the measurement taken at the end of the 2 weeks under normal sodium intake was considered baseline blood pressure . Patients were classified as salt sensitive when a diastolic blood pressure change of 10 mm Hg or more occurred after both low and high periods of sodium intake . In salt-resistant patients treated with indomethacin ( n = 12 , nine men and three women , mean age 50.5 + /- 3.7 years ) , neither blood pressure ( systolic blood pressure from 150.8 + /- 11.2 to 154.6 + /- 9.3 mm Hg , NS ; diastolic blood pressure from 99.3 + /- 2.1 to 101.1 + /- 4.4 mm Hg , NS ) nor the urinary Na+ excretion ( from 108.1 + /- 20.9 to 97.9 + /- 9.1 mmol/24 hr , NS ) was significantly affected by the drug . ( ABSTRACT TRUNCATED AT 250 WORDS Twenty four male hypertensive patients suffering also from peripheral obstructive arterial disease were r and omly subdivided in two groups and after a period of farmacological wash-out of one month Group I was 
    Output:
    