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: The antihypertensive efficacy of the angiotensin II receptor blocker olmesartan medoxomil has been shown to compare favourably with that of other antihypertensive agents . This r and omized , double-blind study compared the antihypertensive efficacy of the starting dose of olmesartan medoxomil with that of the calcium channel blocker amlodipine besylate ( amlodipine ) in subjects with mild-to-moderate hypertension . Following a 4-week , single-blind , placebo run-in period , 440 subjects aged ⩾18 years were r and omized to the starting dose of olmesartan medoxomil ( 20 mg/day ) , amlodipine ( 5 mg/day ) , or placebo for 8 weeks . Subjects were evaluated by  24-h ambulatory blood pressure monitoring ( ABPM ) and by seated cuff blood pressure ( BP ) measurements at trough . The primary end point was the change from baseline in mean 24-h diastolic blood pressure ( DBP ) by ABPM at Week 8 . Secondary end points included change from baseline in mean 24-h ambulatory systolic blood pressure ( SBP ) at 8 weeks , change from baseline in mean seated trough cuff DBP and SBP measurements , and response and control rates for DBP < 90 and < 85 mmHg . Control rates for SBP < 140 and < 130 mmHg were also calculated . Olmesartan medoxomil and amlodipine produced significantly greater reductions in ambulatory and seated DBP and SBP compared with placebo . Mean reductions in ambulatory and seated BP were similar between the two active agents ; however , in the olmesartan medoxomil group , significantly more patients achieved the SBP goal of < 130 mmHg and the DBP goal of < 85 mmHg . Both drugs were well tolerated at the recommended starting dose . Although amlodipine was associated with a higher incidence of oedema , this did not reach statistical significance . Olmesartan medoxomil is an effective antihypertensive agent , with BP-lowering efficacy at the starting dose similar to that of amlodipine , and is associated with more patients achieving the rigorous BP goals of SBP < 130 mmHg and DBP < 85 mmHg Objective To evaluate the antihypertensive effect of lercanidipine once a day at three different doses ( 2.5 , 5 and 10 mg ) by clinic and ambulatory blood pressure . Methods After 3 weeks of a placebo run-in , 243 mild to moderate essential hypertensives ( mean ± SD age 51 ± 8 years ) were r and omly allocated to lercanidipine at 2.5 , 5 or 10 mg or a placebo for 4 weeks , in a double-blind parallel-group design . At the end of each period , supine clinic blood pressure ( st and ard sphygmomanometry ) and 24 h ambulatory blood pressure ( Spacelabs 90207 ) were measured . The duration and homogeneity of the antihypertensive effect of the active drug compared with placebo over 24 h was evaluated by calculating the smoothness index , the ratio of the mean of the 24 hourly blood pressure changes to the corresponding SD . The higher the smoothness index , the greater and the smoother is the antihypertensive effect of a drug over the 24 h. Results In 211 patients with valid clinic blood pressure data at the end of treatment  , larger systolic/diastolic blood pressure reductions were found in the 5 mg ( 10 ± 12/8 ± 6 mmHg ; P < 0.05 versus placebo , diastolic blood pressure only ) and the 10 mg ( 12 ± 1/9 ; ± 7 mmHg ; P < 0.05 versus placebo , both pressures ) lercanidipine groups than in the placebo ( 5 ± 11/4 ± 8 mmHg ) and 2.5 mg lercanidipine ( 7 ± 12/6 ± 7 mmHg ) groups . In 105 patients with complete 24 h  ambulatory blood pressure recordings , there were significantly ( P < 0.05 versus placebo ) larger reductions in the 10 mg ( 9 ± 7/7 ± 5 mmHg ) than the 2.5 mg ( 1 ± 10/1 ± 6 mmHg ) and placebo ( 2 ± 6/1 ± 4 mmHg ) groups . The reduction in 24 h blood pressure with 5 mg lercanidipine ( 6 ± 7/4 ± 5 mmHg ) was significantly greater compared with placebo for diastolic pressure only , and when hourly average blood pressure changes were considered , this reduction did not extend to the final hours of the dosing interval . No significant changes in the clinic or 24 h heart rate were induced by placebo or lercanidipine . The smoothness index was significantly ( P < 0.05 ) lower for 2.5 mg lercanidipine and placebo ( 0.2 ± 0.5 and 0.3 ± 0.7 for systolic and 0.1 ± 0.4 and 0.2 ± 0.7 for diastolic blood pressure ) than for the 5 and 10 mg doses ( 0.7 ± 1 and 1 ± 0.7 for systolic and 0.7 ± 1 and 1 ± 0.9 for diastolic blood pressure ) . Conclusions At a dose of 10 mg , lercanidipine had a significant and durable antihypertensive effect over 24 h , but at 5 mg , the effect was less consistent and did not last 24 h. There was no clinical ly relevant reduction in clinic or ambulatory blood pressure with 2.5 mg lercanidipine , and the effect was superimposable on that of placebo The study was to compare the effects of amlodipine ( calcium channel antagonist ) , chlorthalidone ( diuretic ) , and placebo in adults more than 50 years of age with stage 1 isolated systolic hypertension ( ISH ) . After a 4-week placebo run-in phase , 150 patients were r and omly assigned in a double-blind fashion to treatment with 5 mg of amlodipine ( n = 48 ) , 15 mg of chlorthalidone ( n = 50 ) , or placebo ( n = 52 ) . Patients who failed to meet the systolic blood pressure ( BP ) reduction goal by week 4 had their dose increased to 10 mg of amlodipine or 30 mg of chlorthalidone , and maintained at this increased dose for 12 weeks . Results showed a mean reduction ( mean + /- SD ) in sitting systolic BP from baseline to the last treatment visit of -14.6+/-12.2 mm Hg ( 95 % confidence interval [ CI ] -18.2 , -11.0 ) , -14.0+/-13.46 mm Hg ( 95 % CI -17.8 , -10.2 ) , and -3.4+/-11.83 mm Hg ( 95 % CI -6.7 , -0.1 ) for the amlodipine , chlorthalidone , and the placebo treatment groups , respectively . Both active treatments showed significantly greater reductions than the placebo group ( P < or = .001 ) , but were not significantly different from each other . Sixty-seven percent of the amlodipine , 69 % of the chlorthalidone , and 25 % of the placebo-treated patients reached the protocol defined systolic BP goal ( P = .001 ) . Both active treatment groups showed a trend of better systolic BP response in older patients ( > or = 65 years ) . Secondary efficacy measures including pulse pressure , st and ing systolic , diastolic , and the 24-h ambulatory BP were also statistically significantly improved for both active treatments at the end of treatment , except for chlorthalidone in st and ing diastolic BP . Adverse events that occurred during the study were as expected and were well tolerated . The results of this study support the efficacy and safety of amlodipine and chlorthalidone for the treatment of stage 1 ISH during 20 weeks of treatment Summary . To evaluate the effect of manidipine 10 mg on 24-hour ambulatory blood pressure ( BP ) and heart rate ( HR ) in very elderly hypertensive patients , 54 patients aged 76–89 years ( mean age 81.8 years ) with systolic blood pressure ( SBP ) > 160 mmHg and diastolic blood pressure ( DBP ) > 90 mmHg were studied . After a 4-week placebo washout period , patients were r and omized to receive manidipine 10 mg or placebo , both administered once daily for 8 weeks . Patients were checked after the initial run-in placebo phase and every 4 weeks thereafter . At each visit casual BP and HR were measured . At the end of the placebo period and after 8 weeks of active treatment , noninvasive 24-hour ambulate blood pressure measurement ABPM was performed . Manidipine significantly lowered casual sitting and st and ing SBP ( P < 0.001 ) and DBP ( P < 0.001 ) at the trough level . ABPM showed a significant decrease in 24-hour SBP and DBP values ( P < 0,001 ) , daytime SBP and DBP ( P < 0.001 ) , and night-time SBP ( P < 0.001 ) and DBP ( P < 0.005 ) . In addition , ABPM confirmed a consistent antihypertensive activity throughout the 24-hour dosing interval , without effect on the circadian BP profile . The trough/peak ratio was 0.67 for SBP and 0.59 DBP . No statistically significant change in HR was observed . The treatment was well tolerated , and there were no serious side effects . In conclusion , in very elderly hypertensive patients , once-daily administration of manidipine 10 mg was well tolerated and effective in reducing casual as well ambulatory BP Objective Olmesartan medoxomil is an angiotensin II receptor blocker with similar antihypertensive efficacy as the calcium channel blocker amlodipine besylate in patients with mild-to-moderate hypertension . In addition to a drug 's ability to lower blood pressure , the effectiveness of the agent in enabling patients to achieve specific blood pressure targets is an important clinical consideration . This secondary analysis of a r and omized , double-blind study compared the efficacy of olmesartan medoxomil with that of amlodipine besylate in achieving ambulatory blood pressure goals among patients with mild-to-moderate hypertension . Methods Following a 4-week placebo run-in , 440 study participants aged ≥18 years were r and omized to olmesartan medoxomil ( 20 mg/day ) , amlodipine besylate ( 5 mg/day ) , or placebo for 8 weeks . The proportion of participants achieving specific systolic and diastolic ambulatory blood pressure goal levels was calculated by dividing the number of participants who had achieved a particular blood pressure goal by the total number of patients in the intent-to-treat population . Results After 8 weeks of treatment , a mean 24-h ambulatory blood pressure of < 130/80 or < 130/85 mmHg was achieved by significantly more participants in the olmesartan medoxomil group ( 18.1 and 30.4 % , respectively ) than in the amlodipine besylate ( 7.0 and 14.0 % , respectively ) or placebo ( 1.9 % for both ) groups . The target daytime ambulatory blood pressure of < 135/85 mmHg was achieved by more participants in the olmesartan medoxomil group than in the amlodipine besylate group ( 15.8 vs. 5.8 % , respectively ; P<0.01 ) . Conclusion In a previous publication of the same study , we demonstrated that starting doses of olmesartan medoxomil and amlodipine besylate produced similar mean reductions in blood pressure . In this sub analysis of the blood pressure data from that primary publication , however , olmesartan medoxomil therapy was shown to result in a greater proportion of patients achieving specific ambulatory blood pressure goals than therapy with amlodipine besylate . As blood pressure goal attainment may be of more direct clinical relevance than numerical blood pressure lowering , the achievement of blood pressure goals should be a key efficacy parameter assessed in clinical trials of antihypertensive medications Background Evaluation of combination therapy with antihypertensive agents by clinic blood pressure ( BP ) measurements may yield results that differ from out-of-office BP readings . This is of clinical relevance because out-of-office BP values are of prognostic importance . We studied the effects of combining telmisartan and amlodipine on ambulatory BP in patients with stages 1–2 hypertension . Methods We conducted an 8-week , placebo-controlled , double-blind , 4 × 4 factorial design trial in which 562 patients with clinic diastolic BP at least 95 and 119 mmHg or less were r and omized to receive telmisartan ( 0 , 20 , 40 , or 80 mg ) and /or amlodipine ( 0 , 2.5 , 5 , or 10 mg ) .  Ambulatory BP monitoring  was performed at baseline and after 8 weeks of treatment ; the end points of interest were the changes from baseline in 24- 
    Output:
    
agent
Once-daily dihydropyridine calcium channel blockers appeared to lower blood pressure by a relatively constant amount throughout the 24-hour dosing interval .
Six dihydropyridine calcium channel blockers studied in this review lowered blood pressure by a relatively similar amount each hour over the course of 24 hours .
***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: The antihypertensive efficacy of the angiotensin II receptor blocker olmesartan medoxomil has been shown to compare favourably with that of other antihypertensive agents . This r and omized , double-blind study compared the antihypertensive efficacy of the starting dose of olmesartan medoxomil with that of the calcium channel blocker amlodipine besylate ( amlodipine ) in subjects with mild-to-moderate hypertension . Following a 4-week , single-blind , placebo run-in period , 440 subjects aged ⩾18 years were r and omized to the starting dose of olmesartan medoxomil ( 20 mg/day ) , amlodipine ( 5 mg/day ) , or placebo for 8 weeks . Subjects were evaluated by  24-h ambulatory blood pressure monitoring ( ABPM ) and by seated cuff blood pressure ( BP ) measurements at trough . The primary end point was the change from baseline in mean 24-h diastolic blood pressure ( DBP ) by ABPM at Week 8 . Secondary end points included change from baseline in mean 24-h ambulatory systolic blood pressure ( SBP ) at 8 weeks , change from baseline in mean seated trough cuff DBP and SBP measurements , and response and control rates for DBP < 90 and < 85 mmHg . Control rates for SBP < 140 and < 130 mmHg were also calculated . Olmesartan medoxomil and amlodipine produced significantly greater reductions in ambulatory and seated DBP and SBP compared with placebo . Mean reductions in ambulatory and seated BP were similar between the two active agents ; however , in the olmesartan medoxomil group , significantly more patients achieved the SBP goal of < 130 mmHg and the DBP goal of < 85 mmHg . Both drugs were well tolerated at the recommended starting dose . Although amlodipine was associated with a higher incidence of oedema , this did not reach statistical significance . Olmesartan medoxomil is an effective antihypertensive agent , with BP-lowering efficacy at the starting dose similar to that of amlodipine , and is associated with more patients achieving the rigorous BP goals of SBP < 130 mmHg and DBP < 85 mmHg Objective To evaluate the antihypertensive effect of lercanidipine once a day at three different doses ( 2.5 , 5 and 10 mg ) by clinic and ambulatory blood pressure . Methods After 3 weeks of a placebo run-in , 243 mild to moderate essential hypertensives ( mean ± SD age 51 ± 8 years ) were r and omly allocated to lercanidipine at 2.5 , 5 or 10 mg or a placebo for 4 weeks , in a double-blind parallel-group design . At the end of each period , supine clinic blood pressure ( st and ard sphygmomanometry ) and 24 h ambulatory blood pressure ( Spacelabs 90207 ) were measured . The duration and homogeneity of the antihypertensive effect of the active drug compared with placebo over 24 h was evaluated by calculating the smoothness index , the ratio of the mean of the 24 hourly blood pressure changes to the corresponding SD . The higher the smoothness index , the greater and the smoother is the antihypertensive effect of a drug over the 24 h. Results In 211 patients with valid clinic blood pressure data at the end of treatment  , larger systolic/diastolic blood pressure reductions were found in the 5 mg ( 10 ± 12/8 ± 6 mmHg ; P < 0.05 versus placebo , diastolic blood pressure only ) and the 10 mg ( 12 ± 1/9 ; ± 7 mmHg ; P < 0.05 versus placebo , both pressures ) lercanidipine groups than in the placebo ( 5 ± 11/4 ± 8 mmHg ) and 2.5 mg lercanidipine ( 7 ± 12/6 ± 7 mmHg ) groups . In 105 patients with complete 24 h  ambulatory blood pressure recordings , there were significantly ( P < 0.05 versus placebo ) larger reductions in the 10 mg ( 9 ± 7/7 ± 5 mmHg ) than the 2.5 mg ( 1 ± 10/1 ± 6 mmHg ) and placebo ( 2 ± 6/1 ± 4 mmHg ) groups . The reduction in 24 h blood pressure with 5 mg lercanidipine ( 6 ± 7/4 ± 5 mmHg ) was significantly greater compared with placebo for diastolic pressure only , and when hourly average blood pressure changes were considered , this reduction did not extend to the final hours of the dosing interval . No significant changes in the clinic or 24 h heart rate were induced by placebo or lercanidipine . The smoothness index was significantly ( P < 0.05 ) lower for 2.5 mg lercanidipine and placebo ( 0.2 ± 0.5 and 0.3 ± 0.7 for systolic and 0.1 ± 0.4 and 0.2 ± 0.7 for diastolic blood pressure ) than for the 5 and 10 mg doses ( 0.7 ± 1 and 1 ± 0.7 for systolic and 0.7 ± 1 and 1 ± 0.9 for diastolic blood pressure ) . Conclusions At a dose of 10 mg , lercanidipine had a significant and durable antihypertensive effect over 24 h , but at 5 mg , the effect was less consistent and did not last 24 h. There was no clinical ly relevant reduction in clinic or ambulatory blood pressure with 2.5 mg lercanidipine , and the effect was superimposable on that of placebo The study was to compare the effects of amlodipine ( calcium channel antagonist ) , chlorthalidone ( diuretic ) , and placebo in adults more than 50 years of age with stage 1 isolated systolic hypertension ( ISH ) . After a 4-week placebo run-in phase , 150 patients were r and omly assigned in a double-blind fashion to treatment with 5 mg of amlodipine ( n = 48 ) , 15 mg of chlorthalidone ( n = 50 ) , or placebo ( n = 52 ) . Patients who failed to meet the systolic blood pressure ( BP ) reduction goal by week 4 had their dose increased to 10 mg of amlodipine or 30 mg of chlorthalidone , and maintained at this increased dose for 12 weeks . Results showed a mean reduction ( mean + /- SD ) in sitting systolic BP from baseline to the last treatment visit of -14.6+/-12.2 mm Hg ( 95 % confidence interval [ CI ] -18.2 , -11.0 ) , -14.0+/-13.46 mm Hg ( 95 % CI -17.8 , -10.2 ) , and -3.4+/-11.83 mm Hg ( 95 % CI -6.7 , -0.1 ) for the amlodipine , chlorthalidone , and the placebo treatment groups , respectively . Both active treatments showed significantly greater reductions than the placebo group ( P < or = .001 ) , but were not significantly different from each other . Sixty-seven percent of the amlodipine , 69 % of the chlorthalidone , and 25 % of the placebo-treated patients reached the protocol defined systolic BP goal ( P = .001 ) . Both active treatment groups showed a trend of better systolic BP response in older patients ( > or = 65 years ) . Secondary efficacy measures including pulse pressure , st and ing systolic , diastolic , and the 24-h ambulatory BP were also statistically significantly improved for both active treatments at the end of treatment , except for chlorthalidone in st and ing diastolic BP . Adverse events that occurred during the study were as expected and were well tolerated . The results of this study support the efficacy and safety of amlodipine and chlorthalidone for the treatment of stage 1 ISH during 20 weeks of treatment Summary . To evaluate the effect of manidipine 10 mg on 24-hour ambulatory blood pressure ( BP ) and heart rate ( HR ) in very elderly hypertensive patients , 54 patients aged 76–89 years ( mean age 81.8 years ) with systolic blood pressure ( SBP ) > 160 mmHg and diastolic blood pressure ( DBP ) > 90 mmHg were studied . After a 4-week placebo washout period , patients were r and omized to receive manidipine 10 mg or placebo , both administered once daily for 8 weeks . Patients were checked after the initial run-in placebo phase and every 4 weeks thereafter . At each visit casual BP and HR were measured . At the end of the placebo period and after 8 weeks of active treatment , noninvasive 24-hour ambulate blood pressure measurement ABPM was performed . Manidipine significantly lowered casual sitting and st and ing SBP ( P < 0.001 ) and DBP ( P < 0.001 ) at the trough level . ABPM showed a significant decrease in 24-hour SBP and DBP values ( P < 0,001 ) , daytime SBP and DBP ( P < 0.001 ) , and night-time SBP ( P < 0.001 ) and DBP ( P < 0.005 ) . In addition , ABPM confirmed a consistent antihypertensive activity throughout the 24-hour dosing interval , without effect on the circadian BP profile . The trough/peak ratio was 0.67 for SBP and 0.59 DBP . No statistically significant change in HR was observed . The treatment was well tolerated , and there were no serious side effects . In conclusion , in very elderly hypertensive patients , once-daily administration of manidipine 10 mg was well tolerated and effective in reducing casual as well ambulatory BP Objective Olmesartan medoxomil is an angiotensin II receptor blocker with similar antihypertensive efficacy as the calcium channel blocker amlodipine besylate in patients with mild-to-moderate hypertension . In addition to a drug 's ability to lower blood pressure , the effectiveness of the agent in enabling patients to achieve specific blood pressure targets is an important clinical consideration . This secondary analysis of a r and omized , double-blind study compared the efficacy of olmesartan medoxomil with that of amlodipine besylate in achieving ambulatory blood pressure goals among patients with mild-to-moderate hypertension . Methods Following a 4-week placebo run-in , 440 study participants aged ≥18 years were r and omized to olmesartan medoxomil ( 20 mg/day ) , amlodipine besylate ( 5 mg/day ) , or placebo for 8 weeks . The proportion of participants achieving specific systolic and diastolic ambulatory blood pressure goal levels was calculated by dividing the number of participants who had achieved a particular blood pressure goal by the total number of patients in the intent-to-treat population . Results After 8 weeks of treatment , a mean 24-h ambulatory blood pressure of < 130/80 or < 130/85 mmHg was achieved by significantly more participants in the olmesartan medoxomil group ( 18.1 and 30.4 % , respectively ) than in the amlodipine besylate ( 7.0 and 14.0 % , respectively ) or placebo ( 1.9 % for both ) groups . The target daytime ambulatory blood pressure of < 135/85 mmHg was achieved by more participants in the olmesartan medoxomil group than in the amlodipine besylate group ( 15.8 vs. 5.8 % , respectively ; P<0.01 ) . Conclusion In a previous publication of the same study , we demonstrated that starting doses of olmesartan medoxomil and amlodipine besylate produced similar mean reductions in blood pressure . In this sub analysis of the blood pressure data from that primary publication , however , olmesartan medoxomil therapy was shown to result in a greater proportion of patients achieving specific ambulatory blood pressure goals than therapy with amlodipine besylate . As blood pressure goal attainment may be of more direct clinical relevance than numerical blood pressure lowering , the achievement of blood pressure goals should be a key efficacy parameter assessed in clinical trials of antihypertensive medications Background Evaluation of combination therapy with antihypertensive agents by clinic blood pressure ( BP ) measurements may yield results that differ from out-of-office BP readings . This is of clinical relevance because out-of-office BP values are of prognostic importance . We studied the effects of combining telmisartan and amlodipine on ambulatory BP in patients with stages 1–2 hypertension . Methods We conducted an 8-week , placebo-controlled , double-blind , 4 × 4 factorial design trial in which 562 patients with clinic diastolic BP at least 95 and 119 mmHg or less were r and omized to receive telmisartan ( 0 , 20 , 40 , or 80 mg ) and /or amlodipine ( 0 , 2.5 , 5 , or 10 mg ) .  Ambulatory BP monitoring  was performed at baseline and after 8 weeks of treatment ; the end points of interest were the changes from baseline in 24- 
    Output:
    