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 relative benefits and risks of reserpine and guanethidine were compared in patients with thiazide-treated mild to moderate hypertension ( diastolic pressure 95–115 mm Hg ) . Fortynine ambulant patients ( 30 men , 19 women ) were treated throughout the study with hydrochlorothiazide , 50 mg/day . In this double blind crossover study each drug was added in grade d increments until a predetermined therapeutic response was obtained , blood pressure measurements and side effect scores were evaluated biweekly . Major conclusions of the study were : 1 ) guanethidine , as well as reserpine , will reduce mild to moderate blood pressures to normal ; 2 ) in most cases , side effects which did occur while taking guanethidine or reserpine were well tolerated and neither drug was clearly superior . Side effects associated with larger doses of guanethidine employed in severe hypertension were absent or only slightly bothersome . Thus , guanethidine appears to have a good benefit-to-risk ratio in the therapy of mild to moderate hypertension and offers a number of advantages over drugs commonly used in this syndrome . This study refutes the common belief that guanethidine must be reserved only for the treatment of more severe degrees of hypertension We compared the efficacy and adverse effects of antihypertensive drug regimens in 690 men past age 60 with diastolic blood pressure 90 - 114 mm Hg and systolic blood pressure less than 240 mm Hg . They received either a low ( 25 - 50 mg ) or high ( 50 - 100 mg ) dose of hydrochlorothiazide daily . Of 644 patients who completed the hydrochlorothiazide titration , 375 ( 58.2 % ) were responders ( diastolic blood pressure less than 90 and less than or equal to 5 mm Hg below baseline ) and 92.8 % of these completed a 6-month maintenance period . Blood pressure was reduced from 157.6/98.5 mm Hg by 18.3/9.5 mm Hg with low dose hydrochlorothiazide and by 20.4/9.6 mm Hg with high dose hydrochlorothiazide ; more patients achieved goal blood pressure with the high dose . Whites and blacks responded equally . Serum potassium less than 3.5 mmol/l occurred in 104 of 321 ( 32.3 % ) of the high dose versus 62 of 333 ( 18.6 % ) of the low dose hydrochlorothiazide patients . The 269 nonresponders to hydrochlorothiazide were r and omly assigned in a double-blind study to receive hydralazine , methyldopa , metoprolol , or reserpine in addition to hydrochlorothiazide ; 79.2 % responded to the addition of the second drug and 87.3 % of these completed a 6-month maintenance phase . Overall , there were no significant efficacy differences among the step 2 regimens . We conclude that the lower dose of hydrochlorothiazide was nearly as effective as the higher dose , and the addition of a second drug was effective and generally well tolerated in elderly patients Fifty patients ( 25 Blacks and 25 Indians ) suffering from mild-to-moderate hypertension ( supine diastolic blood pressure 100 - 105 mmHg ) were studied in order to compare the antihypertensive effect of a combination of a beta-blocker ( sotalol hydrochloride 160 mg/d ) plus a thiazide derivative ( hydrochlorothiazide 25 mg/d ) ( Sotazide ; B-M ) with that of a combination of reserpine 0,1 mg/d ( Serpasil ; Ciba ) plus hydrochlorothiazide 25 mg/d ( Dichlotride ; Frosst MSD ) . The combination of reserpine plus hydrochlorothiazide was found to be as effective as that of sotalol plus hydrochlorothiazide in lowering the blood pressure in both the Black and the Indian patients . Two patients taking the combination containing reserpine developed side-effects , but this did not occur in any of those taking the combination containing sotalol . We feel that in developing countries , where the cost of therapy is important , reserpine in a dosage of less than 0,1 mg/d plus a thiazide derivative in low dosage is preferable to a beta-blocker plus a thiazide derivative in the treatment of hypertension The Systolic Hypertension in the Elderly Program ( SHEP ) is a r and omized double-blind placebo-controlled trial to determine if antihypertensive treatment of isolated systolic hypertension ( ISH ) [ systolic blood pressure ( SBP ) greater than or equal to 160 mmHg , diastolic blood pressure ( DBP ) less than 90 mmHg ] reduces the 5 year incidence of fatal and nonfatal stroke . Between March 1 , 1985 and January 15 , 1988 , 4736 persons ( target 4800 ) with ISH , age 60 years and over , were enrolled . Potential participants met blood pressure ( BP ) and age criteria . Those on antihypertensive medication prior to enrollment without documented diastolic hypertension had their medication tapered and discontinued , and then met BP criteria ( 33 % of cohort ) . Stepped-care therapy with chlorthalidone and atenolol ( alternative , reserpine ) or matching placebos was initiated as first and second steps . At baseline the trial population was 43.1 % male , 56.9 % female ; 13.9 % black , 86.1 % non-black . Also , the mean age was 71.6 years ; the mean SBP was 170.3 mmHg and the mean DBP was 76.6 mmHg ; 59.8 % had codeable resting electrocardiographic abnormalities .  The trial is now in follow-up phase with scheduled termination in 1991 The efficacy of thiazide-like chlorthalidone , 50 mg , plus reserpine , 0.25 mg , was compared with that of hydrochlorothiazide , 50 mg , plus reserpine , 0.125 mg , in a six-week double-blind study of 57 patients with essential hypertension unresponsive to diet control and diuretic ( step 1 ) therapy . An average decrease in diastolic pressure of 17.0 mm Hg was attained at the end of week 6 by the chlorthalidone/reserpine group ; the average drop in the hydrochlorothiazide/reserpine group was 18.6 mm Hg . Both treatment groups displayed greater blood pressure control each week than the preceding week ; and , at the end of week 6 , both groups attained control of at least 5 mm Hg below the diastolic goal pressure of 90 mm Hg . The chlorthalidone/reserpine-treated group required fewer titrations than the hydrochlorothiazide/reserpine-treated group . There were no reports of frequent or severe side effects with either drug In a double-blind study to investigate the antihypertensive effect of a fixed triple combination with 0.05 mg reserpine , 2.5 mg clopamide and 0.4 mg dihydroergocristine in comparison to a fixed double combination with 0.05 mg reserpine and 2.5 mg clopamide , a patient subgroup of 34 patients followed a unicenter ( central unit , ' institute ' ) as well as a multicenter ( established physicians ) study design . The patients visited both investigation units on the day of admission to the study ( week 0 ) , after four weeks and after eight weeks of therapy ( after the morning intake of the drugs ) . The paper in h and looks at the results of this subgroup with respect to the conformity of blood pressure values in the two investigative units . The analyses confirm the already published results of the entire study : Both combinations proved to be highly effective antihypertensive drugs . The triple combination showed therapeutical advantages for systolic blood pressure after four weeks , for diastolic pressure after eight weeks of therapy at the ' institute ' as well as , although less distinct , in the medical offices . A comparison of the individual values did not show a convincing coherence of the measurements between institute and offices . All investigated possible systematic sources of error ( different methods of measurement , days or times of measurement ) could be excluded by correlation statistics as a reason for the divergences . The results show the necessity -- particularly in multicenter studies --of a careful documentation of all accompanying data ( e.g. method or time of measurement ) as well as a greatest possible st and ardization of investigation ( e.g. identical measuring apparatus and investigator . A single-blind clinical trial compared step 2 combination therapy consisting of 50 or 100 mg of hydroflumethiazide plus either 0.125 to 0.250 mg of reserpine , 500 to 2,000 mg of methyldopa , or 80 to 320 mg of propranolol hydrochloride , in 59 patients whose elevated blood pressure ( BP ) failed to respond adequately to the thiazide alone . After nine weeks of treatment , diastolic BP was reduced below 90 mm Hg in all 20 patients treated with the  reserpine-hydroflumethiazide combination , in 13 of the 19 patients treated with methyldopa and hydroflumethiazide , and in 16 of the 20 patients treated with propranolol and hydroflumethiazide .  Changes in laboratory values were not substantial ; adverse reactions occurred only in the methyldopa group . Although the three treatment regimens were similar with respect to safety and efficacy , the reserpine-hydroflumethiazide combination offers the advantages of more convenient dosage at lower cost In a double-blind , parallel , 12-week trial , antihypertensive effects of diltiazem and reserpine were compared in 107 patients with essential hypertension .  Diltiazem reduced blood pressure from 176/100 mmHg to 154/86 mmHg after 12 weeks , and reserpine reduced blood pressure from 171/96 mmHg to 155/85 mmHg . The difference between diltiazem and reserpine was not statistically significant . However , among a subset of patients given 180 mg/day of diltiazem , a significantly better antihypertensive effect was achieved than among a subset given 0.3 mg of reserpine . The incidence of side effects and complications in the diltiazem group was about one half that in the reserpine group ( 12.3 % and 27.1 % , respectively ) . Side effects of diltiazem were mild , and the drug was extremely well tolerated . These results show that diltiazem is an effective antihypertensive drug for the treatment of mild to moderate essential hypertension Low-dose combination therapy has been proposed as a rational first-line approach to hypertension treatment . We compared the efficacy and tolerability of the fixed combination of reserpine ( 0.1 mg ) plus the thiazide clopamid ( 5 mg ) with its single components and the calcium-antagonist nitrendipine ( 20 mg ) in a r and omized , double-blind , parallel study of 273 hypertensive patients with diastolic blood pressure ( BP ) between 100 and 114 mm Hg . The four groups did not differ regarding baseline characteristics ( mean age , 58 years ; 51 % men ; mean BP after a 2-week placebo period , 158 to 160/103 to 104 mm Hg ) . After 6 weeks of treatment with one capsule daily , mean reductions in sitting BP from baseline at 24 hours after dosing in the reserpine-clopamid combination , reserpine , clopamid , and nitrendipine groups were -23.0/-17.1 , -14.0/-11.7 , -13.6/-11.9 , and -11.6/-12.3 mm Hg , respectively ( 2P < .01 ) . The corresponding normalization rates ( diastolic BP < 90 mm Hg ) were 55 % , 40 % , 36 % , and 33 % ( 2P = .11 ) . All patients whose BP had not been normalized at this point received two capsules of the respective medication once daily from weeks 7 to 12 . At week 12 , mean BP reductions were -25.7/-18.1 , -14.6/-12.2 , -17.7/-13.4 , and -14.9/-15.3 mm Hg in the four groups , respectively ( 2P < .01 ) . The respective normalization rates were 69 % , 35 % , 39 % , and 45 % ( 2P < .0001 ) . Linear regression modeling indicated that reserpine and clopamid combined acted more than additively . As regards tolerability , adverse experiences were observed in 27 % , 28 % , 29 % , and 48 % of patients , respectively ( 2P < .05 ) . The respective rates of premature discontinuation because of adverse effects were 3 % , 3 % , 7 % , and 13 % ( 2P = .06 ) . In conclusion , a low-dose combination of reserpine and clopamid lowered BP significantly more than both the components alone and nitrendipine . Moreover , the combination was tolerated as well as its components and significantly better than nitrendipine . Thus , the use of this low-dose reserpine-thiazide combination appears to be a rational alternative to conventional monotherapy in the first-line treatment of hypertension In a series of 450 patients with 
    Output:
    
agent
A dose of reserpine 0.5 mg/day or greater achieved the SBP effects .
AUTHORS ' CONCLUSIONS Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs .
***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 relative benefits and risks of reserpine and guanethidine were compared in patients with thiazide-treated mild to moderate hypertension ( diastolic pressure 95–115 mm Hg ) . Fortynine ambulant patients ( 30 men , 19 women ) were treated throughout the study with hydrochlorothiazide , 50 mg/day . In this double blind crossover study each drug was added in grade d increments until a predetermined therapeutic response was obtained , blood pressure measurements and side effect scores were evaluated biweekly . Major conclusions of the study were : 1 ) guanethidine , as well as reserpine , will reduce mild to moderate blood pressures to normal ; 2 ) in most cases , side effects which did occur while taking guanethidine or reserpine were well tolerated and neither drug was clearly superior . Side effects associated with larger doses of guanethidine employed in severe hypertension were absent or only slightly bothersome . Thus , guanethidine appears to have a good benefit-to-risk ratio in the therapy of mild to moderate hypertension and offers a number of advantages over drugs commonly used in this syndrome . This study refutes the common belief that guanethidine must be reserved only for the treatment of more severe degrees of hypertension We compared the efficacy and adverse effects of antihypertensive drug regimens in 690 men past age 60 with diastolic blood pressure 90 - 114 mm Hg and systolic blood pressure less than 240 mm Hg . They received either a low ( 25 - 50 mg ) or high ( 50 - 100 mg ) dose of hydrochlorothiazide daily . Of 644 patients who completed the hydrochlorothiazide titration , 375 ( 58.2 % ) were responders ( diastolic blood pressure less than 90 and less than or equal to 5 mm Hg below baseline ) and 92.8 % of these completed a 6-month maintenance period . Blood pressure was reduced from 157.6/98.5 mm Hg by 18.3/9.5 mm Hg with low dose hydrochlorothiazide and by 20.4/9.6 mm Hg with high dose hydrochlorothiazide ; more patients achieved goal blood pressure with the high dose . Whites and blacks responded equally . Serum potassium less than 3.5 mmol/l occurred in 104 of 321 ( 32.3 % ) of the high dose versus 62 of 333 ( 18.6 % ) of the low dose hydrochlorothiazide patients . The 269 nonresponders to hydrochlorothiazide were r and omly assigned in a double-blind study to receive hydralazine , methyldopa , metoprolol , or reserpine in addition to hydrochlorothiazide ; 79.2 % responded to the addition of the second drug and 87.3 % of these completed a 6-month maintenance phase . Overall , there were no significant efficacy differences among the step 2 regimens . We conclude that the lower dose of hydrochlorothiazide was nearly as effective as the higher dose , and the addition of a second drug was effective and generally well tolerated in elderly patients Fifty patients ( 25 Blacks and 25 Indians ) suffering from mild-to-moderate hypertension ( supine diastolic blood pressure 100 - 105 mmHg ) were studied in order to compare the antihypertensive effect of a combination of a beta-blocker ( sotalol hydrochloride 160 mg/d ) plus a thiazide derivative ( hydrochlorothiazide 25 mg/d ) ( Sotazide ; B-M ) with that of a combination of reserpine 0,1 mg/d ( Serpasil ; Ciba ) plus hydrochlorothiazide 25 mg/d ( Dichlotride ; Frosst MSD ) . The combination of reserpine plus hydrochlorothiazide was found to be as effective as that of sotalol plus hydrochlorothiazide in lowering the blood pressure in both the Black and the Indian patients . Two patients taking the combination containing reserpine developed side-effects , but this did not occur in any of those taking the combination containing sotalol . We feel that in developing countries , where the cost of therapy is important , reserpine in a dosage of less than 0,1 mg/d plus a thiazide derivative in low dosage is preferable to a beta-blocker plus a thiazide derivative in the treatment of hypertension The Systolic Hypertension in the Elderly Program ( SHEP ) is a r and omized double-blind placebo-controlled trial to determine if antihypertensive treatment of isolated systolic hypertension ( ISH ) [ systolic blood pressure ( SBP ) greater than or equal to 160 mmHg , diastolic blood pressure ( DBP ) less than 90 mmHg ] reduces the 5 year incidence of fatal and nonfatal stroke . Between March 1 , 1985 and January 15 , 1988 , 4736 persons ( target 4800 ) with ISH , age 60 years and over , were enrolled . Potential participants met blood pressure ( BP ) and age criteria . Those on antihypertensive medication prior to enrollment without documented diastolic hypertension had their medication tapered and discontinued , and then met BP criteria ( 33 % of cohort ) . Stepped-care therapy with chlorthalidone and atenolol ( alternative , reserpine ) or matching placebos was initiated as first and second steps . At baseline the trial population was 43.1 % male , 56.9 % female ; 13.9 % black , 86.1 % non-black . Also , the mean age was 71.6 years ; the mean SBP was 170.3 mmHg and the mean DBP was 76.6 mmHg ; 59.8 % had codeable resting electrocardiographic abnormalities .  The trial is now in follow-up phase with scheduled termination in 1991 The efficacy of thiazide-like chlorthalidone , 50 mg , plus reserpine , 0.25 mg , was compared with that of hydrochlorothiazide , 50 mg , plus reserpine , 0.125 mg , in a six-week double-blind study of 57 patients with essential hypertension unresponsive to diet control and diuretic ( step 1 ) therapy . An average decrease in diastolic pressure of 17.0 mm Hg was attained at the end of week 6 by the chlorthalidone/reserpine group ; the average drop in the hydrochlorothiazide/reserpine group was 18.6 mm Hg . Both treatment groups displayed greater blood pressure control each week than the preceding week ; and , at the end of week 6 , both groups attained control of at least 5 mm Hg below the diastolic goal pressure of 90 mm Hg . The chlorthalidone/reserpine-treated group required fewer titrations than the hydrochlorothiazide/reserpine-treated group . There were no reports of frequent or severe side effects with either drug In a double-blind study to investigate the antihypertensive effect of a fixed triple combination with 0.05 mg reserpine , 2.5 mg clopamide and 0.4 mg dihydroergocristine in comparison to a fixed double combination with 0.05 mg reserpine and 2.5 mg clopamide , a patient subgroup of 34 patients followed a unicenter ( central unit , ' institute ' ) as well as a multicenter ( established physicians ) study design . The patients visited both investigation units on the day of admission to the study ( week 0 ) , after four weeks and after eight weeks of therapy ( after the morning intake of the drugs ) . The paper in h and looks at the results of this subgroup with respect to the conformity of blood pressure values in the two investigative units . The analyses confirm the already published results of the entire study : Both combinations proved to be highly effective antihypertensive drugs . The triple combination showed therapeutical advantages for systolic blood pressure after four weeks , for diastolic pressure after eight weeks of therapy at the ' institute ' as well as , although less distinct , in the medical offices . A comparison of the individual values did not show a convincing coherence of the measurements between institute and offices . All investigated possible systematic sources of error ( different methods of measurement , days or times of measurement ) could be excluded by correlation statistics as a reason for the divergences . The results show the necessity -- particularly in multicenter studies --of a careful documentation of all accompanying data ( e.g. method or time of measurement ) as well as a greatest possible st and ardization of investigation ( e.g. identical measuring apparatus and investigator . A single-blind clinical trial compared step 2 combination therapy consisting of 50 or 100 mg of hydroflumethiazide plus either 0.125 to 0.250 mg of reserpine , 500 to 2,000 mg of methyldopa , or 80 to 320 mg of propranolol hydrochloride , in 59 patients whose elevated blood pressure ( BP ) failed to respond adequately to the thiazide alone . After nine weeks of treatment , diastolic BP was reduced below 90 mm Hg in all 20 patients treated with the  reserpine-hydroflumethiazide combination , in 13 of the 19 patients treated with methyldopa and hydroflumethiazide , and in 16 of the 20 patients treated with propranolol and hydroflumethiazide .  Changes in laboratory values were not substantial ; adverse reactions occurred only in the methyldopa group . Although the three treatment regimens were similar with respect to safety and efficacy , the reserpine-hydroflumethiazide combination offers the advantages of more convenient dosage at lower cost In a double-blind , parallel , 12-week trial , antihypertensive effects of diltiazem and reserpine were compared in 107 patients with essential hypertension .  Diltiazem reduced blood pressure from 176/100 mmHg to 154/86 mmHg after 12 weeks , and reserpine reduced blood pressure from 171/96 mmHg to 155/85 mmHg . The difference between diltiazem and reserpine was not statistically significant . However , among a subset of patients given 180 mg/day of diltiazem , a significantly better antihypertensive effect was achieved than among a subset given 0.3 mg of reserpine . The incidence of side effects and complications in the diltiazem group was about one half that in the reserpine group ( 12.3 % and 27.1 % , respectively ) . Side effects of diltiazem were mild , and the drug was extremely well tolerated . These results show that diltiazem is an effective antihypertensive drug for the treatment of mild to moderate essential hypertension Low-dose combination therapy has been proposed as a rational first-line approach to hypertension treatment . We compared the efficacy and tolerability of the fixed combination of reserpine ( 0.1 mg ) plus the thiazide clopamid ( 5 mg ) with its single components and the calcium-antagonist nitrendipine ( 20 mg ) in a r and omized , double-blind , parallel study of 273 hypertensive patients with diastolic blood pressure ( BP ) between 100 and 114 mm Hg . The four groups did not differ regarding baseline characteristics ( mean age , 58 years ; 51 % men ; mean BP after a 2-week placebo period , 158 to 160/103 to 104 mm Hg ) . After 6 weeks of treatment with one capsule daily , mean reductions in sitting BP from baseline at 24 hours after dosing in the reserpine-clopamid combination , reserpine , clopamid , and nitrendipine groups were -23.0/-17.1 , -14.0/-11.7 , -13.6/-11.9 , and -11.6/-12.3 mm Hg , respectively ( 2P < .01 ) . The corresponding normalization rates ( diastolic BP < 90 mm Hg ) were 55 % , 40 % , 36 % , and 33 % ( 2P = .11 ) . All patients whose BP had not been normalized at this point received two capsules of the respective medication once daily from weeks 7 to 12 . At week 12 , mean BP reductions were -25.7/-18.1 , -14.6/-12.2 , -17.7/-13.4 , and -14.9/-15.3 mm Hg in the four groups , respectively ( 2P < .01 ) . The respective normalization rates were 69 % , 35 % , 39 % , and 45 % ( 2P < .0001 ) . Linear regression modeling indicated that reserpine and clopamid combined acted more than additively . As regards tolerability , adverse experiences were observed in 27 % , 28 % , 29 % , and 48 % of patients , respectively ( 2P < .05 ) . The respective rates of premature discontinuation because of adverse effects were 3 % , 3 % , 7 % , and 13 % ( 2P = .06 ) . In conclusion , a low-dose combination of reserpine and clopamid lowered BP significantly more than both the components alone and nitrendipine . Moreover , the combination was tolerated as well as its components and significantly better than nitrendipine . Thus , the use of this low-dose reserpine-thiazide combination appears to be a rational alternative to conventional monotherapy in the first-line treatment of hypertension In a series of 450 patients with 
    Output:
    