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: Abstract Background . The lowering of cholesterol concentrations in individuals at high risk for cardiovascular disease improves clinical outcome . Xuezhikang has a marked impact on lipids . Methods . In this r and omized , double-blinded , placebo-controlled , parallel-group clinical trial , a total of 2704 hypertensive patients with previous myocardial infa rct ion ( MI ) were assigned either to placebo ( n = 1341 ) or to Xuezhikang ( 0.6 g twice daily , n = 1363 ) for an average of 4.5 years . The primary end-point was recurrent coronary events ; the secondary end-point was all-cause mortality and other clinical events , including adverse effects . Results . There were no differences between the Xuezhikang and placebo group in base-line characteristics . However , Xuezhikang treatment reduced the incidence of coronary events by 43.0 % ( P = 0.02 ) , deaths from coronary heart disease ( CHD ) by 30.0 % ( P < 0.01 ) , and all-cause mortality by 35.8 % ( P = 0.001 ) . Conclusions . This study , for the first time , demonstrated that long-term Xuezhikang therapy result ed in significant reduction in cardiovascular events and death in Chinese hypertensive patients with previous MI in a safe manner Lipid-lowering therapy in individuals with high risk of cardiovascular disease reduces the incidence of coronary heart disease . However , few studies have assessed the benefits of cholesterol lowering for primary prevention of coronary heart disease in hypertensive patients with mild dyslipidemia or without conventional dyslipidemia . The large , r and omized Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese Study showed a 33 % reduction in coronary heart disease incidence with pravastatin as the primary prevention in Japanese patients . We conducted an exploratory analysis of the effect of diet plus pravastatin therapy on the primary prevention of cardiovascular events ( coronary heart disease , coronary heart disease plus cerebral infa rct ion , and cardiovascular disease ) in the 3277 patients with hypertension during the 5-year follow-up . There were no significant differences in mean baseline total cholesterol , blood pressure levels , or variation in blood pressure during the 5-year period between the diet ( n=1664 ) and diet plus pravastatin ( n=1613 ) groups . In the diet plus pravastatin group , the relative risk of coronary heart disease plus cerebral infa rct ion was reduced by 35 % ( hazard ratio : 0.65 ; CI : 0.46 to 0.93 ; P=0.02 ) , cerebral infa rct ion by 46 % ( hazard ratio : 0.54 ; CI : 0.29 to 0.98 ; P=0.04 ) , and cardiovascular disease by 33 % ( hazard ratio : 0.67 ; CI : 0.49 to 0.91 ; P=0.01 ) . In patients without a history of cardiovascular disease who have hypertension and mildly elevated cholesterol , pravastatin was effective in reducing the incidence of cardiovascular disease , particularly cerebral infa rct ion . Hence , in patients with hypertension with mildly elevated cholesterol levels , treatment with a statin is advisable to reduce the burden of cardiovascular disease Objective To observe the effect of combined therapy with Xuezhikang Capsule ( 血脂康胶囊 , XZK ) and Valsartan on left ventricular hypertrophy ( LVH ) and heart rate turbulence ( HRT ) in hypertensive patients . Methods Ninety primary hypertensive patients with LVH were r and omly assigned to three groups . Basic treatment , including aspirin , β-blockers , calcium antagonists , etc . were administered to all patients . Additionally , Valsartan ( VS , 80 mg once a day ) was given to the 30 patients in the VS group . Valsartan ( in the same dosage ) and XZK ( 600 mg , twice a day ) were given to the 32 patients in the Chinese medicine ( CM ) group , while none was given to the 28 patients in the control group . The therapeutic course lasted for 24 months . Changes in left ventricular mass index ( LVMI ) measured by cardiac ultrasonic indices , HRT parameters , including the original heart rate ( TO ) and slope coeffificient ( TS ) , systolic and diastolic blood pressures ( SBP and DBP ) , as well as blood cholesterol level ( TC ) were measured before and after treatment . Results After treatment , TO and LVMI were lowered , while TS increased in both the VS group and the CM group ( P<0.01 ) , but changed insignificantly in the control group . Significant differences between the CM group and the control group were shown in terms of TO , LVMI , SBP , DBP and TS ( P<0.01 ) ; and between the CM group and the VS group in terms of TO , LVMI and TS ( P<0.01 ) . Moreover , HRT parameters showed an evident correlation with LVMI ( r=0.519–0.635 , P<0.01 ) . Conclusion Combined therapy with XZK and Valsartan can improve hypertensive LVH and HRT parameters , and lessen the damage on the autonomous nervous system Summary Background The lowering of cholesterol concentrations in individuals at high risk of cardiovascular disease improves outcome . No study , however , has assessed benefits of cholesterol lowering in the primary prevention of coronary heart disease ( CHD ) in hypertensive patients who are not conventionally deemed dyslipidaemic . Methods Of 19 342 hypertensive patients ( aged 40–79 years with at least three other cardiovascular risk factors ) r and omised to one of two antihypertensive regimens in the Anglo-Sc and inavian Cardiac Outcomes Trial , 10 305 with nonfasting total cholesterol concentrations 6.5 mmol/L or less were r and omly assigned additional atorvastatin 10 mg or placebo .  These patients formed the lipid-lowering arm of the study . We planned follow-up for an average of 5 years , the primary endpoint being non-fatal myocardial infa rct ion and fatal CHD . Data were analysed by intention to treat . Findings Treatment was stopped after a median follow-up of 3.3 years . By that time , 100 primary events had occurred in the atorvastatin group compared with 154 events in the placebo group ( hazard ratio 0.64 [ 95 % CI 0.50–0.83 ] , p = 0.0005 ) . This benefit emerged in the first year of follow-up . There was no significant heterogeneity among prespecified subgroups . Fatal and non-fatal stroke ( 89 atorvastatin vs 121 placebo , 0.73 [ 0.56–0.96 ] , p = 0.024 ) , total cardiovascular events ( 389 vs 486 , 0.79 [ 0.69–0.90 ] , p = 0.0005 ) , and total coronary events ( 178 vs 247 , 0.71 [ 0.59–0.86 ] , p = 0.0005 ) were also significantly lowered . There were 185 deaths in the atorvastatin group and 212 in the placebo group ( 0.87 [ 0.71–1.06 ] , p = 0.16 ) . Atorvastatin  lowered total serum cholesterol by about 1.3 mmol/L compared with placebo at 12 months , and by 1.1 mmol/L after 3 years of follow-up . Interpretation The reductions in major cardiovascular events with atorvastatin are large , given the short follow-up time . These findings may have implication s for future lipid-lowering guidelines BACKGROUND We examined the cholesterol-lowering effects of a proprietary Chinese red-yeast-rice supplement in an American population consuming a diet similar to the American Heart Association Step I diet using a double-blind , placebo-controlled , prospect ively r and omized 12-wk controlled trial at a university research center . OBJECTIVE We evaluated the lipid-lowering effects of this red-yeast-rice dietary supplement in US adults separate from effects of diet alone . DESIGN Eighty-three healthy subjects ( 46 men and 37 women aged 34 - 78 y ) with hyperlipidemia [ total cholesterol , 5.28 - 8.74 mmol/L ( 204 - 338 mg/dL ) ; LDL cholesterol , 3.31 - 7.16 mmol/L ( 128 - 277 mg/dL ) ; triacylglycerol , 0.62 - 2.78 mmol/L ( 55 - 246 mg/dL ) ; and HDL cholesterol 0.78 - 2.46 mmol/L ( 30 - 95 mg/dL ) ] who were not being treated with lipid-lowering drugs participated . Subjects were treated with red yeast rice ( 2.4 g/d ) or placebo and instructed to consume a diet providing 30 % of energy from fat , < 10 % from saturated fat , and < 300 mg cholesterol daily . Main outcome measures were total cholesterol , total triacylglycerol , and HDL and LDL cholesterol measured at weeks 8 , 9 , 11 , and 12 . RESULTS Total cholesterol concentrations decreased significantly between baseline and 8 wk in the red-yeast-rice-treated group compared with the placebo-treated group [ ( x+/-SD ) 6.57+/-0.93 mmol/L ( 254+/-36 mg/dL ) to 5.38+/-0.80 mmol/L ( 208+/-31 mg/dL ) ; P < 0.001 ] . LDL cholesterol and total triacylglycerol were also reduced with the supplement . HDL cholesterol did not change significantly . CONCLUSIONS Red yeast rice significantly reduces total cholesterol , LDL cholesterol , and total triacylglycerol concentrations compared with placebo and provides a new , novel , food-based approach to lowering cholesterol in the general population BACKGROUND Some studies have suggested reductions in blood pressure (BP)with statin treatment , particularly in persons with hypertension . R and omized trial evidence is limited . METHODS We performed a r and omized , double-blind , placebo-controlled trial with equal allocation to simvastatin , 20 mg ; pravastatin sodium,40 mg ; or placebo for 6 months . Nine hundred seventy-three men and women without known cardiovascular disease or diabetes mellitus , with low-density lipoprotein cholesterol screening levels of 115 to 190 mg/dL , had assessment of systolic and diastolic BP ( SBP and DBP , respectively ) .  Blood pressure values were compared for placebo vs statins by intention-to-treat ( ITT ) analysis . Additional analyses were performed that ( 1 ) were confined to subjects with neither high baseline BP ( SBP>140 mm Hg or DBP>90 mm Hg ) nor receiving BP medications , to exclude groups in whom BP medications or medication changes may have influenced results , and ( 2 ) separately evaluated simvastatin and pravastatin ( vs placebo ) . The time course of BP changes after statin initiation and the effect of stopping statins on BP were examined . RESULTS Statins modestly but significantly reduced BP relative to placebo , by 2.2 mm Hg for SBP ( P=.02 ) and 2.4 mm Hg for DBP ( P<.001 ) in ITT analysis . Blood pressure reductions ranged from 2.4 to 2.8 mm Hg for both SBP and DBP with both simvastatin and pravastatin , in those subjects with full follow-up , and without potential for influence by BP medications ( ie , neither receiving nor meriting BP medications ) . CONCLUSIONS Reductions in SBP and DBP occurred with hydrophilic and lipophilic statins and extended to normotensive subjects . These modest effects may contribute to the reduced risk of stroke and cardiovascular events reported on statins . Trial Registration clinical trials.gov Identifier : NCT00330980 BACKGROUND AND AIM Some clinical evidence supports a statin antihypertensive effect . Our aim is to evaluate the statin effect on blood pressure control in hypertensive patients in the setting of clinical practice , and the role of some predetermined individual patient characteristics ( age , gender , baseline BP levels , pre-treatment LDL-C levels ) on the supposed statin BP lowering effect . METHODS AND RESULTS Two hundred and fifty-four hypertensive patients with hypercholesterolemia were enrolled in the Ambulatory service of the Hypertension Research Unit of Bologna University Hospital . After 2 - 4 weeks of a run-in period patients were allocated to statin treatment and followed-up for 24 weeks . The blood pressure response to statins was compared in several subgroups of patients according to age , gender , baseline BP and pre-treatment cholesterolemia . In the overall study population , the use of statins was associated with a significant reduction in systolic ( -7.6+/- 
    Output:
    
agent
“ RYR plus conventional therapy ” exhibited significant lowering effects on serum total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , and CRP but exhibited no significant effect on systolic BP , diastolic BP , triglycerides ( TG ) , and high-density lipoprotein cholesterol ( HDL-C ) compared with “ placebo plus conventional therapy . ” “
RYR plus conventional therapy ” showed significant lowering effects on systolic BP , TC , LDL-C , and CRP but no effect on diastolic BP , TG , and HDL-C compared with “ placebo plus conventional therapy . ”
No significant difference in BP and lipid profile between “ RYR plus conventional therapy ” and “ statins plus conventional therapy ” was observed .
“ RYR plus statins ” appeared to be more effective in lowering BP , TC , TG , and LDL-C but without a significant difference in HDL-C compared to statins .
No serious adverse events were reported .
The results of this meta- analysis suggested some supportive but limited evidence regarding RYR for hypertension .
***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: Abstract Background . The lowering of cholesterol concentrations in individuals at high risk for cardiovascular disease improves clinical outcome . Xuezhikang has a marked impact on lipids . Methods . In this r and omized , double-blinded , placebo-controlled , parallel-group clinical trial , a total of 2704 hypertensive patients with previous myocardial infa rct ion ( MI ) were assigned either to placebo ( n = 1341 ) or to Xuezhikang ( 0.6 g twice daily , n = 1363 ) for an average of 4.5 years . The primary end-point was recurrent coronary events ; the secondary end-point was all-cause mortality and other clinical events , including adverse effects . Results . There were no differences between the Xuezhikang and placebo group in base-line characteristics . However , Xuezhikang treatment reduced the incidence of coronary events by 43.0 % ( P = 0.02 ) , deaths from coronary heart disease ( CHD ) by 30.0 % ( P < 0.01 ) , and all-cause mortality by 35.8 % ( P = 0.001 ) . Conclusions . This study , for the first time , demonstrated that long-term Xuezhikang therapy result ed in significant reduction in cardiovascular events and death in Chinese hypertensive patients with previous MI in a safe manner Lipid-lowering therapy in individuals with high risk of cardiovascular disease reduces the incidence of coronary heart disease . However , few studies have assessed the benefits of cholesterol lowering for primary prevention of coronary heart disease in hypertensive patients with mild dyslipidemia or without conventional dyslipidemia . The large , r and omized Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese Study showed a 33 % reduction in coronary heart disease incidence with pravastatin as the primary prevention in Japanese patients . We conducted an exploratory analysis of the effect of diet plus pravastatin therapy on the primary prevention of cardiovascular events ( coronary heart disease , coronary heart disease plus cerebral infa rct ion , and cardiovascular disease ) in the 3277 patients with hypertension during the 5-year follow-up . There were no significant differences in mean baseline total cholesterol , blood pressure levels , or variation in blood pressure during the 5-year period between the diet ( n=1664 ) and diet plus pravastatin ( n=1613 ) groups . In the diet plus pravastatin group , the relative risk of coronary heart disease plus cerebral infa rct ion was reduced by 35 % ( hazard ratio : 0.65 ; CI : 0.46 to 0.93 ; P=0.02 ) , cerebral infa rct ion by 46 % ( hazard ratio : 0.54 ; CI : 0.29 to 0.98 ; P=0.04 ) , and cardiovascular disease by 33 % ( hazard ratio : 0.67 ; CI : 0.49 to 0.91 ; P=0.01 ) . In patients without a history of cardiovascular disease who have hypertension and mildly elevated cholesterol , pravastatin was effective in reducing the incidence of cardiovascular disease , particularly cerebral infa rct ion . Hence , in patients with hypertension with mildly elevated cholesterol levels , treatment with a statin is advisable to reduce the burden of cardiovascular disease Objective To observe the effect of combined therapy with Xuezhikang Capsule ( 血脂康胶囊 , XZK ) and Valsartan on left ventricular hypertrophy ( LVH ) and heart rate turbulence ( HRT ) in hypertensive patients . Methods Ninety primary hypertensive patients with LVH were r and omly assigned to three groups . Basic treatment , including aspirin , β-blockers , calcium antagonists , etc . were administered to all patients . Additionally , Valsartan ( VS , 80 mg once a day ) was given to the 30 patients in the VS group . Valsartan ( in the same dosage ) and XZK ( 600 mg , twice a day ) were given to the 32 patients in the Chinese medicine ( CM ) group , while none was given to the 28 patients in the control group . The therapeutic course lasted for 24 months . Changes in left ventricular mass index ( LVMI ) measured by cardiac ultrasonic indices , HRT parameters , including the original heart rate ( TO ) and slope coeffificient ( TS ) , systolic and diastolic blood pressures ( SBP and DBP ) , as well as blood cholesterol level ( TC ) were measured before and after treatment . Results After treatment , TO and LVMI were lowered , while TS increased in both the VS group and the CM group ( P<0.01 ) , but changed insignificantly in the control group . Significant differences between the CM group and the control group were shown in terms of TO , LVMI , SBP , DBP and TS ( P<0.01 ) ; and between the CM group and the VS group in terms of TO , LVMI and TS ( P<0.01 ) . Moreover , HRT parameters showed an evident correlation with LVMI ( r=0.519–0.635 , P<0.01 ) . Conclusion Combined therapy with XZK and Valsartan can improve hypertensive LVH and HRT parameters , and lessen the damage on the autonomous nervous system Summary Background The lowering of cholesterol concentrations in individuals at high risk of cardiovascular disease improves outcome . No study , however , has assessed benefits of cholesterol lowering in the primary prevention of coronary heart disease ( CHD ) in hypertensive patients who are not conventionally deemed dyslipidaemic . Methods Of 19 342 hypertensive patients ( aged 40–79 years with at least three other cardiovascular risk factors ) r and omised to one of two antihypertensive regimens in the Anglo-Sc and inavian Cardiac Outcomes Trial , 10 305 with nonfasting total cholesterol concentrations 6.5 mmol/L or less were r and omly assigned additional atorvastatin 10 mg or placebo .  These patients formed the lipid-lowering arm of the study . We planned follow-up for an average of 5 years , the primary endpoint being non-fatal myocardial infa rct ion and fatal CHD . Data were analysed by intention to treat . Findings Treatment was stopped after a median follow-up of 3.3 years . By that time , 100 primary events had occurred in the atorvastatin group compared with 154 events in the placebo group ( hazard ratio 0.64 [ 95 % CI 0.50–0.83 ] , p = 0.0005 ) . This benefit emerged in the first year of follow-up . There was no significant heterogeneity among prespecified subgroups . Fatal and non-fatal stroke ( 89 atorvastatin vs 121 placebo , 0.73 [ 0.56–0.96 ] , p = 0.024 ) , total cardiovascular events ( 389 vs 486 , 0.79 [ 0.69–0.90 ] , p = 0.0005 ) , and total coronary events ( 178 vs 247 , 0.71 [ 0.59–0.86 ] , p = 0.0005 ) were also significantly lowered . There were 185 deaths in the atorvastatin group and 212 in the placebo group ( 0.87 [ 0.71–1.06 ] , p = 0.16 ) . Atorvastatin  lowered total serum cholesterol by about 1.3 mmol/L compared with placebo at 12 months , and by 1.1 mmol/L after 3 years of follow-up . Interpretation The reductions in major cardiovascular events with atorvastatin are large , given the short follow-up time . These findings may have implication s for future lipid-lowering guidelines BACKGROUND We examined the cholesterol-lowering effects of a proprietary Chinese red-yeast-rice supplement in an American population consuming a diet similar to the American Heart Association Step I diet using a double-blind , placebo-controlled , prospect ively r and omized 12-wk controlled trial at a university research center . OBJECTIVE We evaluated the lipid-lowering effects of this red-yeast-rice dietary supplement in US adults separate from effects of diet alone . DESIGN Eighty-three healthy subjects ( 46 men and 37 women aged 34 - 78 y ) with hyperlipidemia [ total cholesterol , 5.28 - 8.74 mmol/L ( 204 - 338 mg/dL ) ; LDL cholesterol , 3.31 - 7.16 mmol/L ( 128 - 277 mg/dL ) ; triacylglycerol , 0.62 - 2.78 mmol/L ( 55 - 246 mg/dL ) ; and HDL cholesterol 0.78 - 2.46 mmol/L ( 30 - 95 mg/dL ) ] who were not being treated with lipid-lowering drugs participated . Subjects were treated with red yeast rice ( 2.4 g/d ) or placebo and instructed to consume a diet providing 30 % of energy from fat , < 10 % from saturated fat , and < 300 mg cholesterol daily . Main outcome measures were total cholesterol , total triacylglycerol , and HDL and LDL cholesterol measured at weeks 8 , 9 , 11 , and 12 . RESULTS Total cholesterol concentrations decreased significantly between baseline and 8 wk in the red-yeast-rice-treated group compared with the placebo-treated group [ ( x+/-SD ) 6.57+/-0.93 mmol/L ( 254+/-36 mg/dL ) to 5.38+/-0.80 mmol/L ( 208+/-31 mg/dL ) ; P < 0.001 ] . LDL cholesterol and total triacylglycerol were also reduced with the supplement . HDL cholesterol did not change significantly . CONCLUSIONS Red yeast rice significantly reduces total cholesterol , LDL cholesterol , and total triacylglycerol concentrations compared with placebo and provides a new , novel , food-based approach to lowering cholesterol in the general population BACKGROUND Some studies have suggested reductions in blood pressure (BP)with statin treatment , particularly in persons with hypertension . R and omized trial evidence is limited . METHODS We performed a r and omized , double-blind , placebo-controlled trial with equal allocation to simvastatin , 20 mg ; pravastatin sodium,40 mg ; or placebo for 6 months . Nine hundred seventy-three men and women without known cardiovascular disease or diabetes mellitus , with low-density lipoprotein cholesterol screening levels of 115 to 190 mg/dL , had assessment of systolic and diastolic BP ( SBP and DBP , respectively ) .  Blood pressure values were compared for placebo vs statins by intention-to-treat ( ITT ) analysis . Additional analyses were performed that ( 1 ) were confined to subjects with neither high baseline BP ( SBP>140 mm Hg or DBP>90 mm Hg ) nor receiving BP medications , to exclude groups in whom BP medications or medication changes may have influenced results , and ( 2 ) separately evaluated simvastatin and pravastatin ( vs placebo ) . The time course of BP changes after statin initiation and the effect of stopping statins on BP were examined . RESULTS Statins modestly but significantly reduced BP relative to placebo , by 2.2 mm Hg for SBP ( P=.02 ) and 2.4 mm Hg for DBP ( P<.001 ) in ITT analysis . Blood pressure reductions ranged from 2.4 to 2.8 mm Hg for both SBP and DBP with both simvastatin and pravastatin , in those subjects with full follow-up , and without potential for influence by BP medications ( ie , neither receiving nor meriting BP medications ) . CONCLUSIONS Reductions in SBP and DBP occurred with hydrophilic and lipophilic statins and extended to normotensive subjects . These modest effects may contribute to the reduced risk of stroke and cardiovascular events reported on statins . Trial Registration clinical trials.gov Identifier : NCT00330980 BACKGROUND AND AIM Some clinical evidence supports a statin antihypertensive effect . Our aim is to evaluate the statin effect on blood pressure control in hypertensive patients in the setting of clinical practice , and the role of some predetermined individual patient characteristics ( age , gender , baseline BP levels , pre-treatment LDL-C levels ) on the supposed statin BP lowering effect . METHODS AND RESULTS Two hundred and fifty-four hypertensive patients with hypercholesterolemia were enrolled in the Ambulatory service of the Hypertension Research Unit of Bologna University Hospital . After 2 - 4 weeks of a run-in period patients were allocated to statin treatment and followed-up for 24 weeks . The blood pressure response to statins was compared in several subgroups of patients according to age , gender , baseline BP and pre-treatment cholesterolemia . In the overall study population , the use of statins was associated with a significant reduction in systolic ( -7.6+/- 
    Output:
    