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: Fourteen patients with mild to moderate essential hypertension were r and omized , after a baseline placebo period of 4 weeks , to receive the angiotensin converting enzyme ( ACE ) inhibitor quinapril or a placebo . During a 12 week , double-blind phase , the dosage of quinapril was increased from 10 to 40 mg twice daily being doubled every 4 weeks . At the end of the baseline period and of each month of the double-blind phase , 12 h overnight urine collection s were made and morning blood sample s were taken about 12 h after the last dose of medication . During the double-blind phase , blood pressure in the  quinapril  group ( n = 7 ) decreased from 159 ± 3/105 ± 1 to 141 ± 6/94 ± 2 mm Hg ( mean ± SEM ) . Serum ACE activity and plasma angiotensin II concentration were reduced to 4 ± 1 % and 14 ± 1 % of the pretreatment values , respectively . Neither the plasma concentrations nor the urinary excretions of prostagl and in E2 , 6-keto-prostagl and in F1α ( a prostacyclin metabolite ) , or thromboxane B2 ( a metabolite of thromboxane A2 ) were affected by quinapril . In the placebo group , blood pressure tended to decline but the biochemical variables remained essentially unchanged . These results indicate that prostanoids are not involved in the antihypertensive action of quinapril , the principal effect of which seems to be inhibition of the renin-angiotensin system Summary The presence of slightly increased urinary albumin excretion ( UAE ) , even at levels well below levels detectable by an ordinary dipstick , has been suggested as a predictor of cardiovascular morbidity and as a reflection of the degree of overall vascular permeability . The aim of the present investigation was to study the effects of two different antihypertensive drug regimens , an ACE inhibitor and aβ-adrenoceptor antagonist , on the low UAE rate observed in subjects with uncomplicated , mild to moderate primary hypertension . After a 4-week placebo run-in period , 49 patients ( mean age 54 y ) were r and omly assigned in a double blind manner either to further 4 weeks on placebo ( P , n = 15 ) , 8 weeks on lisinopril ( L , n = 17 ; 20 mg/40 mg o. d. ) or 8 weeks on atenolol ( A , n = 17 ; 50 mg/100 mg o. d. ) . The 24-h UAE was measured every second week . At entry and after 4 weeks the glomerular filtration rate and the renal plasma flow were measured . Both drugs lowered blood pressure ( BP ) to a similar extent after 4 and 8 weeks of treatment ; the blood pressures were 160/106 ( P ) , 159/104 ( L ) and 154/103 ( A ) at entry , and 133/83 ( L ) and 134/87 ( A ) at the end of the study after 8 weeks . On entry the 24-h UAE in all patients ranged from 4 to 49 mg ( mean 14.1 mg ) , and it did not differ significantly between groups . After 4 weeks the UAE during 24 h was reduced by approximately one third in the lisinopril-treated group , and by 10 % in the atenolol reated group , whereas it remained unaltered in the group on placebo . After 8 weeks the 24-hour UAE was approximately 20 % lower compared to baseline levels in the lisinopril-treated patients . In the atenolol-treated group the UAE was unaltered compared to baseline . However , none of the changes in the UAE was statistically significant , nor were there any statistically significant differences between the two antihypertensive regimens . Moreover , there were no significant effect of the lisinopril or atenolol  treatment on renal function or on renal haemodynamics . It is concluded that in patients with uncomplicated , mild to moderate hypertension both an ACE-inhibitor , such as lisinopril , as well as aβ1-selective adrenoceptor blocking agent , such as In a double-blind , parallel-group study , 260 patients with mild to severe essential hypertension were r and omized to treatment with placebo or spirapril at 6 , 12 or 24 mg once daily for 6 weeks . When blood pressures were measured at the end of the dosing interval ( trough ) , all spirapril regimens had produced similar reductions in sitting systolic and diastolic blood pressures ( siSBP/siDBP ) which were significantly greater than those observed in placebo-treated patients . There were no relevant changes in resting heart rate in any of the study groups . At the study endpoint , the mean reductions in siSBP/siDBP were 14.9/11.5 mmHg with spirapril at 6 mg , 15.4/12.0 mmHg with spirapril at 12 mg and 17.8/12.4 mmHg with spirapril at 24 mg/day vs. 3.1/3.6 mmHg with placebo . In a subgroup of 122 patients , blood pressure was recorded at the end of the dosing interval and during the 8 hours immediately postdose to monitor the peak effects on blood pressure . All spirapril dosages produced similar reductions at peak with a mean decrease of siDBP of approximately 20 mmHg in comparison to baseline values vs 6 - 7 mmHg with placebo . The trough : peak ratios for 6 , 12 and 24 mg all lay between 60 % and 90 % for siSBP and siDBP , indicating that most of the peak effect was maintained at trough . Spirapril was well tolerated ; the adverse event profile was not different from that with placebo , and no dose-related adverse events were observed . ( ABSTRACT TRUNCATED AT 250 WORDS Dry cough is a troublesome side-effect associated with certain antihypertensive agents that act by modulating aspects of the renin-angiotensin-aldosterone system . The incidence of dry cough associated with two of these therapies , the novel All receptor antagonist telmisartan and the ACE inhibitor lisinopril , was assessed in a multicentre , r and omised , parallel-group , double-blind , placebo-controlled , 8-week study of 88 patients with mild to moderate hypertension who previously demonstrated ACE inhibitor-related cough . Patients received either telmisartan 80 mg , lisinopril 20 mg , or placebo once daily . Cough incidence , measured at each visit by a self-administered symptom assessment question naire , was significantly higher with lisinopril ( 60 % ) than with telmisartan ( 15.6 % ) or placebo ( 9.7 % ) . A visual analogue scale demonstrated a similar trend for cough frequency . Thus the incidence of cough with telmisartan 80 mg is significantly less than that seen with lisinopril 20 mg and is comparable to placebo 1 . We describe an approach involving a smaller , shorter study , leading onto a longer , larger study in which the antihypertensive effects of ascending doses of imidapril , a new ACE inhibitor , were investigated . Both studies were planned prospect ively , assuming a clinical ly useful fall in BP to be 8 mm Hg ( s.d . = 9 ) . The studies included patients with mild to moderate essential hypertension ( baseline sitting diastolic blood pressure ( SDBP ) 95 - 115 mm Hg ) . After a placebo run-in of 2 - 3 weeks patients received either placebo or imidapril 2.5 , 5 , 10 or 20 mg in the 2 week study ( n = 91 ) or imidapril 5 , 10 , 20 or 40 mg in the 4 week study ( n = 162 ) . 2 . The overall mean baseline SDBP was 103.4 mm Hg ( s.d . 0.62 ) in the initial study and 101.5 mm Hg ( s.d . 0.41 ) in the 4 week study . 3 . Compared with placebo , imidapril 10 , 20 and 40 mg significantly reduced SDBP . There was no significant difference between these doses , suggesting that 10 mg achieved maximal ACE inhibition in most patients . The 2.5 mg dose showed no significant effect . The 5 mg dose gave an intermediate effect . In both studies the overall incidence of adverse events was similar in the imidapril and placebo groups , and was not worrying In a double-blind , r and omized , cross-over , placebo- and rest-period controlled study with two 4-week treatment periods , we examined the effects of angiotensin converting enzyme ( ACE ) inhibition with fosinopril ( 20 mg/day ) on the postexercise  pressor and forearm vasoconstrictor responses to a 60 sec cold pressor test . The results indicate that pressor and vasoconstrictor responses were unaffected by prior exercise , fosinopril , and both interventions combined . Expression of the responses as percent change from baseline levels provided identical results indicating that changes in baseline values did not mask an altered vascular responsiveness . It is concluded that skeletal muscle vascular responsiveness to sympathetic nervous activity is unchanged after exercise or during ACE inhibition with fosinopril Co-administration of antihypertensive drug therapy and hormonal replacement therapy ( HRT ) is frequent in postmenopausal women but it is not known whether HRT interacts with concomitant antihypertensive therapy . The present study was design ed to investigate efficacy and safety of the ACE inhibitor moexipril in comparison to placebo in hypertensive , postmenopausal women on HRT . After a 4-week placebo run-in phase , 95 postmenopausal women ( 35–74 years of age ) who had a sitting diastolic blood pressure ( BP ) of 95–114 mm Hg and were treated with HRT were r and omised to a 12-week treatment with moexipril 15 mg or placebo .  Efficacy and safety were assessed by measuring changes in sitting BP and metabolic parameters associated with cardiovascular disease including triglycerides , total cholesterol , HDL , LDL , total cholesterol/HDL ratio and glucose . Adverse events were recorded continuously . After 12 weeks of treatment , moexipril 15 mg was significantly more effective in reducing sitting systolic and diastolic BP from baseline than placebo ( −12.2/ −9.9 mm Hg vs −1.6/−4.3 mm Hg , P < 0.001 ) . metabolic parameters were not affected by treatment with moexipril  : mean levels of triglycerides , total cholesterol , hdl , ldl , total cholesterol/hdl ratio and glucose remained unchanged throughout the study . fibrinogen , an independent cardiovascular risk factor , increased after placebo ( + 35.0 mg/dl ) and decreased after treatment with moexipril ( −33.6 mg/dl ) , the difference , however , was not statistically significant .  moexipril  was well-tolerated by postmenopausal women using hrt . the most frequent adverse events included headache ( 21.3 % ) , cough ( 12.8 % ) and rhinitis ( 10.6 % ) and there were no significant differences in the number and severity of adverse events between the moexipril and placebo groups . this study indicates that moexipril is effective and well tolerated in the treatment of hypertensive , postmenopausal women and can safely be co-administered to hrt Cilazapril ( CLZ ) is a new , long-acting nonsulfhydril converting enzyme inhibitor ( ACE-I ) . Its effect on peak and trough sitting diastolic blood pressure ( SDBP ) was studied in a total of 85 patients with uncomplicated , essential hypertension at three centers . After 4 weeks of a single-blind placebo ( PLA ) run-in period , patients whose SDBP was between 100 and 115 mm Hg , were r and omized into active treatment with either PLA ( n = 27 ) , CLZ 2.5 mg ( n = 29 ) , or CLZ 5 mg ( n = 29 ) once daily in a double-blind fashion for another 8 weeks . At the end of the PLA run-in and after 4 and 8 weeks active therapy , an hourly blood pressure ( BP ) profile during 1–10 and 21–24 h postdose was performed . The drop in SDBP at the end of the active treatment period at peak and trough was statistically and clinical ly significant for both CLZ doses in comparison with the PLA group . The peak/trough ratio after substraction of the PLA effect was 62 % for CLZ 2.5 mg and 59 % for CLZ 5 mg . These results indicate that the dose regimen of CLZ 2.5–5 mg once daily is adequate and effective for 24 Two hundred and eleven patients with mild or moderate hypertension , mean age 53.5 + /- 9.5 years ( range 24 - 70 ) were r and omised double-blind to treatment with either captopril 50 mg ( C50 ) , hydrochlorothiazide 25 mg ( HCTZ 25 ) , the fixed combination of captopril 50 mg and hydrochlorothiazide 25 mg ( C50/HCTZ 25 ) or placebo . 
    Output:
    
agent
The data do not suggest that any one ACE inhibitor is better or worse at lowering BP .
ACE inhibitor doses above Max did not significantly lower BP more than Max .
There are no clinical ly meaningful BP lowering differences between different ACE inhibitors .
***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: Fourteen patients with mild to moderate essential hypertension were r and omized , after a baseline placebo period of 4 weeks , to receive the angiotensin converting enzyme ( ACE ) inhibitor quinapril or a placebo . During a 12 week , double-blind phase , the dosage of quinapril was increased from 10 to 40 mg twice daily being doubled every 4 weeks . At the end of the baseline period and of each month of the double-blind phase , 12 h overnight urine collection s were made and morning blood sample s were taken about 12 h after the last dose of medication . During the double-blind phase , blood pressure in the  quinapril  group ( n = 7 ) decreased from 159 ± 3/105 ± 1 to 141 ± 6/94 ± 2 mm Hg ( mean ± SEM ) . Serum ACE activity and plasma angiotensin II concentration were reduced to 4 ± 1 % and 14 ± 1 % of the pretreatment values , respectively . Neither the plasma concentrations nor the urinary excretions of prostagl and in E2 , 6-keto-prostagl and in F1α ( a prostacyclin metabolite ) , or thromboxane B2 ( a metabolite of thromboxane A2 ) were affected by quinapril . In the placebo group , blood pressure tended to decline but the biochemical variables remained essentially unchanged . These results indicate that prostanoids are not involved in the antihypertensive action of quinapril , the principal effect of which seems to be inhibition of the renin-angiotensin system Summary The presence of slightly increased urinary albumin excretion ( UAE ) , even at levels well below levels detectable by an ordinary dipstick , has been suggested as a predictor of cardiovascular morbidity and as a reflection of the degree of overall vascular permeability . The aim of the present investigation was to study the effects of two different antihypertensive drug regimens , an ACE inhibitor and aβ-adrenoceptor antagonist , on the low UAE rate observed in subjects with uncomplicated , mild to moderate primary hypertension . After a 4-week placebo run-in period , 49 patients ( mean age 54 y ) were r and omly assigned in a double blind manner either to further 4 weeks on placebo ( P , n = 15 ) , 8 weeks on lisinopril ( L , n = 17 ; 20 mg/40 mg o. d. ) or 8 weeks on atenolol ( A , n = 17 ; 50 mg/100 mg o. d. ) . The 24-h UAE was measured every second week . At entry and after 4 weeks the glomerular filtration rate and the renal plasma flow were measured . Both drugs lowered blood pressure ( BP ) to a similar extent after 4 and 8 weeks of treatment ; the blood pressures were 160/106 ( P ) , 159/104 ( L ) and 154/103 ( A ) at entry , and 133/83 ( L ) and 134/87 ( A ) at the end of the study after 8 weeks . On entry the 24-h UAE in all patients ranged from 4 to 49 mg ( mean 14.1 mg ) , and it did not differ significantly between groups . After 4 weeks the UAE during 24 h was reduced by approximately one third in the lisinopril-treated group , and by 10 % in the atenolol reated group , whereas it remained unaltered in the group on placebo . After 8 weeks the 24-hour UAE was approximately 20 % lower compared to baseline levels in the lisinopril-treated patients . In the atenolol-treated group the UAE was unaltered compared to baseline . However , none of the changes in the UAE was statistically significant , nor were there any statistically significant differences between the two antihypertensive regimens . Moreover , there were no significant effect of the lisinopril or atenolol  treatment on renal function or on renal haemodynamics . It is concluded that in patients with uncomplicated , mild to moderate hypertension both an ACE-inhibitor , such as lisinopril , as well as aβ1-selective adrenoceptor blocking agent , such as In a double-blind , parallel-group study , 260 patients with mild to severe essential hypertension were r and omized to treatment with placebo or spirapril at 6 , 12 or 24 mg once daily for 6 weeks . When blood pressures were measured at the end of the dosing interval ( trough ) , all spirapril regimens had produced similar reductions in sitting systolic and diastolic blood pressures ( siSBP/siDBP ) which were significantly greater than those observed in placebo-treated patients . There were no relevant changes in resting heart rate in any of the study groups . At the study endpoint , the mean reductions in siSBP/siDBP were 14.9/11.5 mmHg with spirapril at 6 mg , 15.4/12.0 mmHg with spirapril at 12 mg and 17.8/12.4 mmHg with spirapril at 24 mg/day vs. 3.1/3.6 mmHg with placebo . In a subgroup of 122 patients , blood pressure was recorded at the end of the dosing interval and during the 8 hours immediately postdose to monitor the peak effects on blood pressure . All spirapril dosages produced similar reductions at peak with a mean decrease of siDBP of approximately 20 mmHg in comparison to baseline values vs 6 - 7 mmHg with placebo . The trough : peak ratios for 6 , 12 and 24 mg all lay between 60 % and 90 % for siSBP and siDBP , indicating that most of the peak effect was maintained at trough . Spirapril was well tolerated ; the adverse event profile was not different from that with placebo , and no dose-related adverse events were observed . ( ABSTRACT TRUNCATED AT 250 WORDS Dry cough is a troublesome side-effect associated with certain antihypertensive agents that act by modulating aspects of the renin-angiotensin-aldosterone system . The incidence of dry cough associated with two of these therapies , the novel All receptor antagonist telmisartan and the ACE inhibitor lisinopril , was assessed in a multicentre , r and omised , parallel-group , double-blind , placebo-controlled , 8-week study of 88 patients with mild to moderate hypertension who previously demonstrated ACE inhibitor-related cough . Patients received either telmisartan 80 mg , lisinopril 20 mg , or placebo once daily . Cough incidence , measured at each visit by a self-administered symptom assessment question naire , was significantly higher with lisinopril ( 60 % ) than with telmisartan ( 15.6 % ) or placebo ( 9.7 % ) . A visual analogue scale demonstrated a similar trend for cough frequency . Thus the incidence of cough with telmisartan 80 mg is significantly less than that seen with lisinopril 20 mg and is comparable to placebo 1 . We describe an approach involving a smaller , shorter study , leading onto a longer , larger study in which the antihypertensive effects of ascending doses of imidapril , a new ACE inhibitor , were investigated . Both studies were planned prospect ively , assuming a clinical ly useful fall in BP to be 8 mm Hg ( s.d . = 9 ) . The studies included patients with mild to moderate essential hypertension ( baseline sitting diastolic blood pressure ( SDBP ) 95 - 115 mm Hg ) . After a placebo run-in of 2 - 3 weeks patients received either placebo or imidapril 2.5 , 5 , 10 or 20 mg in the 2 week study ( n = 91 ) or imidapril 5 , 10 , 20 or 40 mg in the 4 week study ( n = 162 ) . 2 . The overall mean baseline SDBP was 103.4 mm Hg ( s.d . 0.62 ) in the initial study and 101.5 mm Hg ( s.d . 0.41 ) in the 4 week study . 3 . Compared with placebo , imidapril 10 , 20 and 40 mg significantly reduced SDBP . There was no significant difference between these doses , suggesting that 10 mg achieved maximal ACE inhibition in most patients . The 2.5 mg dose showed no significant effect . The 5 mg dose gave an intermediate effect . In both studies the overall incidence of adverse events was similar in the imidapril and placebo groups , and was not worrying In a double-blind , r and omized , cross-over , placebo- and rest-period controlled study with two 4-week treatment periods , we examined the effects of angiotensin converting enzyme ( ACE ) inhibition with fosinopril ( 20 mg/day ) on the postexercise  pressor and forearm vasoconstrictor responses to a 60 sec cold pressor test . The results indicate that pressor and vasoconstrictor responses were unaffected by prior exercise , fosinopril , and both interventions combined . Expression of the responses as percent change from baseline levels provided identical results indicating that changes in baseline values did not mask an altered vascular responsiveness . It is concluded that skeletal muscle vascular responsiveness to sympathetic nervous activity is unchanged after exercise or during ACE inhibition with fosinopril Co-administration of antihypertensive drug therapy and hormonal replacement therapy ( HRT ) is frequent in postmenopausal women but it is not known whether HRT interacts with concomitant antihypertensive therapy . The present study was design ed to investigate efficacy and safety of the ACE inhibitor moexipril in comparison to placebo in hypertensive , postmenopausal women on HRT . After a 4-week placebo run-in phase , 95 postmenopausal women ( 35–74 years of age ) who had a sitting diastolic blood pressure ( BP ) of 95–114 mm Hg and were treated with HRT were r and omised to a 12-week treatment with moexipril 15 mg or placebo .  Efficacy and safety were assessed by measuring changes in sitting BP and metabolic parameters associated with cardiovascular disease including triglycerides , total cholesterol , HDL , LDL , total cholesterol/HDL ratio and glucose . Adverse events were recorded continuously . After 12 weeks of treatment , moexipril 15 mg was significantly more effective in reducing sitting systolic and diastolic BP from baseline than placebo ( −12.2/ −9.9 mm Hg vs −1.6/−4.3 mm Hg , P < 0.001 ) . metabolic parameters were not affected by treatment with moexipril  : mean levels of triglycerides , total cholesterol , hdl , ldl , total cholesterol/hdl ratio and glucose remained unchanged throughout the study . fibrinogen , an independent cardiovascular risk factor , increased after placebo ( + 35.0 mg/dl ) and decreased after treatment with moexipril ( −33.6 mg/dl ) , the difference , however , was not statistically significant .  moexipril  was well-tolerated by postmenopausal women using hrt . the most frequent adverse events included headache ( 21.3 % ) , cough ( 12.8 % ) and rhinitis ( 10.6 % ) and there were no significant differences in the number and severity of adverse events between the moexipril and placebo groups . this study indicates that moexipril is effective and well tolerated in the treatment of hypertensive , postmenopausal women and can safely be co-administered to hrt Cilazapril ( CLZ ) is a new , long-acting nonsulfhydril converting enzyme inhibitor ( ACE-I ) . Its effect on peak and trough sitting diastolic blood pressure ( SDBP ) was studied in a total of 85 patients with uncomplicated , essential hypertension at three centers . After 4 weeks of a single-blind placebo ( PLA ) run-in period , patients whose SDBP was between 100 and 115 mm Hg , were r and omized into active treatment with either PLA ( n = 27 ) , CLZ 2.5 mg ( n = 29 ) , or CLZ 5 mg ( n = 29 ) once daily in a double-blind fashion for another 8 weeks . At the end of the PLA run-in and after 4 and 8 weeks active therapy , an hourly blood pressure ( BP ) profile during 1–10 and 21–24 h postdose was performed . The drop in SDBP at the end of the active treatment period at peak and trough was statistically and clinical ly significant for both CLZ doses in comparison with the PLA group . The peak/trough ratio after substraction of the PLA effect was 62 % for CLZ 2.5 mg and 59 % for CLZ 5 mg . These results indicate that the dose regimen of CLZ 2.5–5 mg once daily is adequate and effective for 24 Two hundred and eleven patients with mild or moderate hypertension , mean age 53.5 + /- 9.5 years ( range 24 - 70 ) were r and omised double-blind to treatment with either captopril 50 mg ( C50 ) , hydrochlorothiazide 25 mg ( HCTZ 25 ) , the fixed combination of captopril 50 mg and hydrochlorothiazide 25 mg ( C50/HCTZ 25 ) or placebo . 
    Output:
    