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 objectives of our study were to assess the reproducibility of the trough-to-peak ratio ( T/P ) and to see whether a high T/P is accompanied by more organ protection or vice versa . The study included 175 ( mean+/-SD age , 51+/-9 years ) subjects with mild-moderate essential hypertension who had echocardiographic evidence of left ventricular ( LV ) hypertrophy taken from the SAMPLE study ( Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation ) , an open-label multicenter study . The study included a 3-week washout pretreatment period , a 12-month treatment period with lisinopril ( n=84 ) or lisinopril plus hydrochlorothiazide ( n=91 ) once daily , and a 4-week placebo follow-up period . Results of 24-hour ambulatory blood pressure monitoring and echocardiographic determination of left ventricular mass index ( LVMI ) were obtained before and after 3 and 12 months of treatment . T/Ps were computed in each patient by dividing the systolic and diastolic blood pressure changes at trough ( changes in the last 2 hours of the monitoring period ) by those at peak ( average of the 2 adjacent hours with the maximal blood pressure reduction between the 2nd and 8th hour from drug intake ) after 3 and 12 months of treatment . Average 24-hour blood pressure was similarly reduced at 3 and 12 months . Trough blood pressure changes at 3 and 12 months were closely correlated , as were the corresponding peak blood pressure changes . However , the 3- and 12-month T/Ps correlated to a lesser degree ( r<0.42 ) . Furthermore , the reduction of LVMI induced by treatment was similarly correlated with the treatment-induced reduction in 24-hour average , trough , and peak blood pressures but not with the T/Ps . This was also evident when the contribution to LV hypertrophy regression by 24-hour blood pressure changes and T/Ps was assessed in a multivariate regression analysis . In patients with a T/P > /=0.5 or < 0.5 , the regression of LVMI was similar . In conclusion , peak and trough blood pressure changes are reproducible and predict the regression of LVMI induced by treatment as well as average 24-hour blood pressure . T/Ps are less reproducible , and their value does not predict regression of organ damage by antihypertensive treatment An 8-week , multicenter , double-blind , r and omized , parallel-group , forced-titration study was conducted to evaluate the antihypertensive efficacy of c and esartan vs. losartan in 654 hypertensive patients with a diastolic blood pressure between 95 and 114 mm Hg from 72 sites throughout the U.S. Eligible patients were r and omized to c and esartan cilexetil 16 mg once daily , or losartan 50 mg once daily . Two weeks following r and omization , patients doubled the respective doses of their angiotensin receptor blockers for an additional 6 weeks . At week 8 , c and esartan cilexetil lowered trough systolic/diastolic blood pressure by a significantly greater amount than did losartan ( 13.3/10.9 mm Hg with c and esartan cilexetil vs. 9.8/8.7 mm Hg with losartan ; p less than 0.001 ) . At the same period , c and esartan cilexetil also lowered peak blood pressure by a significantly greater amount than did losartan ( 15.2 to 11.6 mm Hg with c and esartan cilexetil vs. 12.6 to 10.1 mm Hg with losartan ; p less than 0.05 ) . There were statistically significantly ( p less than 0.05 ) higher proportions of responders and controlled patients in the c and esartan cilexetil group ( 62.4 % and 56.0 % , respectively ) than in the losartan group ( 54.0 % and 46.9 % , respectively ) . Both treatment regimens were well tolerated ; 1.8 % in the c and esartan cilexetil group and 1.6 % in the losartan group withdrew because of adverse events . In conclusion , this forced-titration study confirms that c and esartan cilexetil is more effective than losartan in lowering blood pressure when both are administered once daily at maximum doses . Both drugs were well tolerated . (c)2001 by Le Jacq An 8-week , multicentre ( 72 sites in the US ) , double-blind , r and omised , parallel group , forced titration study compared the antihypertensive efficacy of c and esartan cilexetil and losartan .  A total of 611 patients with essential hypertension ( diastolic blood pressure 95 to 114 mm Hg ) were r and omised initially to c and esartan cilexetil 16 mg once daily or losartan 50 mg once daily . After 2 weeks of r and omised treatment , the doses of c and esartan cilexetil and losartan were doubled to 32 mg and 100 mg once daily and continued respectively for 6 weeks . At week 8 , c and esartan cilexetil lowered the blood pressure ( BP ) at 24 h ( trough ) , 6 h ( peak ) and 48 h post dose to a significantly greater extent ( P < 0.05 ) than losartan : c and esartan cilexetil lowered trough BP by 13.4/10.5 mm Hg , peak BP by 15.5/12.9 mm Hg and 48-h BP by 10.5/9.9 mm Hg compared to a reduction of trough BP by 10.1/9.1 mm Hg , peak BP by 12.0/9.5 mm Hg , and 48-h BP by 5.9/7.0 mm Hg by losartan . The responder and control rates were numerically higher in the c and esartan cilexetil group , but the differences did not reach statistical significance ; the responder rates were 58.8 % for the c and esartan cilexetil group and 52.1 % for the losartan group and control rates were 49.0 % for the c and esartan cilexetil group and 44.6 % for the losartan group . Overall , both treatment regimens were well tolerated . A total of 15 of the 611 ( 2.5 % ) patients withdrew from the study due to an adverse event , including nine ( 2.9 % ) in the c and esartan cilexetil group and six ( 2.0 % ) in the losartan group . In conclusion , this forced titration study confirms that c and esartan cilexetil is more effective in lowering BP than losartan when compared at once daily maximum doses This double-blind , r and omised , controlled study compared the efficacy of c and esartan cilexetil 8 mg ( n = 87 ) and losartan 50 mg ( n = 89 ) , once daily for 6 weeks , relative to placebo  ( n = 80 ) in patients with mild-to-moderate essential hypertension ( diastolic blood pressure ( DBP ) : 95 - 115 mmHg ) . Ambulatory BP measurements were done every 15 min over 36 h. At the end of the 6-week treatment , the mean change in DBP between the baseline and the 0 - 24-h period after the last dose of study medication was greater in patients receiving c and esartan cilexetil 8 mg ( -7.3 mmHg + /- 6.9 mmHg ) compared with losartan 50 mg ( -5.1 mmHg + /- 4.9 mmHg ) ( p < 0.05 ) or placebo ( 0.3 mmHg + /- 6.5 mmHg ) ( p < 0.001 ) . The mean change in systolic BP ( SBP ) during this time was greater in patients receiving c and esartan cilexetil 8 mg ( -10.8 mmHg + /- 11.3 mmHg ) , or losartan 50 mg ( -8.8 mmHg + /- 8.9 mmHg ) than placebo ( 1.2 mmHg + /- 9.9 mmHg ) ( p < 0.001 ) . C and esartan cilexetil 8 mg was associated with a greater reduction in DBP and SBP , relative to placebo , when compared with losartan 50 mg , during both daytime and night-time , and between 12 and 24 h after dosing ( p < 0.001 ) . Both active treatments were well tolerated . In patients with mild-to-moderate essential hypertension , c and esartan cilexetil 8 mg therefore had greater , more consistent antihypertensive efficacy throughout the day and the night , and long-lasting efficacy after the last dose , compared with losartan 50 mg . This greater efficacy is maintained with an excellent tolerability associated with members of the angiotensin Il type 1-receptor blocker class Objective To introduce a new method , the smoothness index , for assessing the homogeneity of 24 h blood pressure reduction by antihypertensive treatment and to compare it with the trough : peak ratio ; and to assess the ability of both indices to predict a reduction in the left ventricular mass index induced by treatment . Patients and methods In 174 patients with essential hypertension and left ventricular hypertrophy , enrolled in the Study on Ambulatory Monitoring of Pressure and Lisinopril Evaluation ( SAMPLE ) , aged 20–65 years , we measured clinic blood pressure , 24 h ambulatory blood pressure and the left ventricular mass index ( echocardiography ) before and after treatment with lisinopril at 20 mg with the addition of 12.5 or 25 mg hydrochlorothiazide as needed to reach a sufficient blood pressure reduction . The following parameters were computed for systolic and diastolic ambulatory blood pressure : ( 1 ) hourly and 24 h blood pressure averages ( ± SD ) at baseline and after 3 and 12 months of treatment ; ( 2 ) hourly blood pressure changes from baseline after 3 and 12 months of treatment , and their average ( ± SD ) over 24 h ; ( 3 ) the trough : peak ratio after 3 and 12 months of treatment ; and ( 4 ) the smoothness index after 3 and 12 months of treatment . Similar calculations were also performed at the end of a final study month during which active treatment was withdrawn and placebo was substituted ( n = 164 ) . Results The smoothness index for systolic and diastolic ambulatory blood pressure computed after 3 months of treatment was more closely related to its corresponding values after 12 months of treatment than the trough : peak ratio values computed after the same time periods were ( r = 0.68 versus 0.38 for systolic and 0.68 versus 0.42 for diastolic blood pressure , respectively ) . The smoothness index showed an inverse correlation with the 24 h st and ard deviation of systolic and diastolic blood pressure ( r = −0.25 and −0.16 , P < 0.01 and < 0.05 , respectively , for 12 months of treatment ) , while the trough : peak ratio did not ( r = −0.01 to −0.12 , NS ) . A treatment-induced reduction in the left ventricular mass index was related to the smoothness index for systolic and diastolic blood pressure ( r = −0.35 and −0.32 , P < 0.001 with 12 months of treatment ) , but not to the corresponding trough : peak ratios . Conclusions The smoothness index identifies the occurrence of a balanced 24 h blood pressure reduction with treatment and correlates with the favourable effects of treatment on left ventricular hypertrophy better than the commonly used trough : peak ratio The antihypertensive activity of losartan potassium ( losartan , Cozaar ) , an angiotensin II receptor antagonist , was evaluated in a parallel 12-week , double-blind , placebo-controlled trial in hypertensive patients with mild-to-moderate hypertension . After a 4-week , single-blind , placebo lead-in period , which included monitoring of baseline variables , 366 patients with a group mean sitting diastolic blood pressure of 101 + /- 5 ( s.d . ) mmHg were assigned r and omly to one of three treatment groups : placebo , losartan 50 mg , or losartan 50 mg with the option to titrate to 100 mg after the first 6 weeks if the target sitting diastolic blood pressure ( < 90 mmHg ) was not reached . To assess the potential blood pressure response associated with the act of titration , patients in the placebo and losartan 50 mg treatment groups with a sitting diastolic blood pressure of > or = 90 mmHg at week 6 were mock titrated ( changed to a new tablet containing the same study medication and dose ) . Sitting diastolic blood pressure was also evaluated at the end of the trial during a 1-week off-drug period to assess for rebound hypertension . At week 6 , patients in the active-drug-treatment arms experienced significantly greater peak ( 6 h post-dose ) and trough ( 24 h post-dose ) reduction in systolic and diastolic sitting blood pressures compared with placebo ( p < or = 0.01 ) . Based on trough blood pressures at week 12 , active drug ( both arms ) was more effective than placebo in lowering sitting diastolic 
    Output:
    
agent
Conclusions : C and esartan is superior to losartan in reducing blood pressure .
C and esartan also causes fewer serious adverse events than losartan
***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 objectives of our study were to assess the reproducibility of the trough-to-peak ratio ( T/P ) and to see whether a high T/P is accompanied by more organ protection or vice versa . The study included 175 ( mean+/-SD age , 51+/-9 years ) subjects with mild-moderate essential hypertension who had echocardiographic evidence of left ventricular ( LV ) hypertrophy taken from the SAMPLE study ( Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation ) , an open-label multicenter study . The study included a 3-week washout pretreatment period , a 12-month treatment period with lisinopril ( n=84 ) or lisinopril plus hydrochlorothiazide ( n=91 ) once daily , and a 4-week placebo follow-up period . Results of 24-hour ambulatory blood pressure monitoring and echocardiographic determination of left ventricular mass index ( LVMI ) were obtained before and after 3 and 12 months of treatment . T/Ps were computed in each patient by dividing the systolic and diastolic blood pressure changes at trough ( changes in the last 2 hours of the monitoring period ) by those at peak ( average of the 2 adjacent hours with the maximal blood pressure reduction between the 2nd and 8th hour from drug intake ) after 3 and 12 months of treatment . Average 24-hour blood pressure was similarly reduced at 3 and 12 months . Trough blood pressure changes at 3 and 12 months were closely correlated , as were the corresponding peak blood pressure changes . However , the 3- and 12-month T/Ps correlated to a lesser degree ( r<0.42 ) . Furthermore , the reduction of LVMI induced by treatment was similarly correlated with the treatment-induced reduction in 24-hour average , trough , and peak blood pressures but not with the T/Ps . This was also evident when the contribution to LV hypertrophy regression by 24-hour blood pressure changes and T/Ps was assessed in a multivariate regression analysis . In patients with a T/P > /=0.5 or < 0.5 , the regression of LVMI was similar . In conclusion , peak and trough blood pressure changes are reproducible and predict the regression of LVMI induced by treatment as well as average 24-hour blood pressure . T/Ps are less reproducible , and their value does not predict regression of organ damage by antihypertensive treatment An 8-week , multicenter , double-blind , r and omized , parallel-group , forced-titration study was conducted to evaluate the antihypertensive efficacy of c and esartan vs. losartan in 654 hypertensive patients with a diastolic blood pressure between 95 and 114 mm Hg from 72 sites throughout the U.S. Eligible patients were r and omized to c and esartan cilexetil 16 mg once daily , or losartan 50 mg once daily . Two weeks following r and omization , patients doubled the respective doses of their angiotensin receptor blockers for an additional 6 weeks . At week 8 , c and esartan cilexetil lowered trough systolic/diastolic blood pressure by a significantly greater amount than did losartan ( 13.3/10.9 mm Hg with c and esartan cilexetil vs. 9.8/8.7 mm Hg with losartan ; p less than 0.001 ) . At the same period , c and esartan cilexetil also lowered peak blood pressure by a significantly greater amount than did losartan ( 15.2 to 11.6 mm Hg with c and esartan cilexetil vs. 12.6 to 10.1 mm Hg with losartan ; p less than 0.05 ) . There were statistically significantly ( p less than 0.05 ) higher proportions of responders and controlled patients in the c and esartan cilexetil group ( 62.4 % and 56.0 % , respectively ) than in the losartan group ( 54.0 % and 46.9 % , respectively ) . Both treatment regimens were well tolerated ; 1.8 % in the c and esartan cilexetil group and 1.6 % in the losartan group withdrew because of adverse events . In conclusion , this forced-titration study confirms that c and esartan cilexetil is more effective than losartan in lowering blood pressure when both are administered once daily at maximum doses . Both drugs were well tolerated . (c)2001 by Le Jacq An 8-week , multicentre ( 72 sites in the US ) , double-blind , r and omised , parallel group , forced titration study compared the antihypertensive efficacy of c and esartan cilexetil and losartan .  A total of 611 patients with essential hypertension ( diastolic blood pressure 95 to 114 mm Hg ) were r and omised initially to c and esartan cilexetil 16 mg once daily or losartan 50 mg once daily . After 2 weeks of r and omised treatment , the doses of c and esartan cilexetil and losartan were doubled to 32 mg and 100 mg once daily and continued respectively for 6 weeks . At week 8 , c and esartan cilexetil lowered the blood pressure ( BP ) at 24 h ( trough ) , 6 h ( peak ) and 48 h post dose to a significantly greater extent ( P < 0.05 ) than losartan : c and esartan cilexetil lowered trough BP by 13.4/10.5 mm Hg , peak BP by 15.5/12.9 mm Hg and 48-h BP by 10.5/9.9 mm Hg compared to a reduction of trough BP by 10.1/9.1 mm Hg , peak BP by 12.0/9.5 mm Hg , and 48-h BP by 5.9/7.0 mm Hg by losartan . The responder and control rates were numerically higher in the c and esartan cilexetil group , but the differences did not reach statistical significance ; the responder rates were 58.8 % for the c and esartan cilexetil group and 52.1 % for the losartan group and control rates were 49.0 % for the c and esartan cilexetil group and 44.6 % for the losartan group . Overall , both treatment regimens were well tolerated . A total of 15 of the 611 ( 2.5 % ) patients withdrew from the study due to an adverse event , including nine ( 2.9 % ) in the c and esartan cilexetil group and six ( 2.0 % ) in the losartan group . In conclusion , this forced titration study confirms that c and esartan cilexetil is more effective in lowering BP than losartan when compared at once daily maximum doses This double-blind , r and omised , controlled study compared the efficacy of c and esartan cilexetil 8 mg ( n = 87 ) and losartan 50 mg ( n = 89 ) , once daily for 6 weeks , relative to placebo  ( n = 80 ) in patients with mild-to-moderate essential hypertension ( diastolic blood pressure ( DBP ) : 95 - 115 mmHg ) . Ambulatory BP measurements were done every 15 min over 36 h. At the end of the 6-week treatment , the mean change in DBP between the baseline and the 0 - 24-h period after the last dose of study medication was greater in patients receiving c and esartan cilexetil 8 mg ( -7.3 mmHg + /- 6.9 mmHg ) compared with losartan 50 mg ( -5.1 mmHg + /- 4.9 mmHg ) ( p < 0.05 ) or placebo ( 0.3 mmHg + /- 6.5 mmHg ) ( p < 0.001 ) . The mean change in systolic BP ( SBP ) during this time was greater in patients receiving c and esartan cilexetil 8 mg ( -10.8 mmHg + /- 11.3 mmHg ) , or losartan 50 mg ( -8.8 mmHg + /- 8.9 mmHg ) than placebo ( 1.2 mmHg + /- 9.9 mmHg ) ( p < 0.001 ) . C and esartan cilexetil 8 mg was associated with a greater reduction in DBP and SBP , relative to placebo , when compared with losartan 50 mg , during both daytime and night-time , and between 12 and 24 h after dosing ( p < 0.001 ) . Both active treatments were well tolerated . In patients with mild-to-moderate essential hypertension , c and esartan cilexetil 8 mg therefore had greater , more consistent antihypertensive efficacy throughout the day and the night , and long-lasting efficacy after the last dose , compared with losartan 50 mg . This greater efficacy is maintained with an excellent tolerability associated with members of the angiotensin Il type 1-receptor blocker class Objective To introduce a new method , the smoothness index , for assessing the homogeneity of 24 h blood pressure reduction by antihypertensive treatment and to compare it with the trough : peak ratio ; and to assess the ability of both indices to predict a reduction in the left ventricular mass index induced by treatment . Patients and methods In 174 patients with essential hypertension and left ventricular hypertrophy , enrolled in the Study on Ambulatory Monitoring of Pressure and Lisinopril Evaluation ( SAMPLE ) , aged 20–65 years , we measured clinic blood pressure , 24 h ambulatory blood pressure and the left ventricular mass index ( echocardiography ) before and after treatment with lisinopril at 20 mg with the addition of 12.5 or 25 mg hydrochlorothiazide as needed to reach a sufficient blood pressure reduction . The following parameters were computed for systolic and diastolic ambulatory blood pressure : ( 1 ) hourly and 24 h blood pressure averages ( ± SD ) at baseline and after 3 and 12 months of treatment ; ( 2 ) hourly blood pressure changes from baseline after 3 and 12 months of treatment , and their average ( ± SD ) over 24 h ; ( 3 ) the trough : peak ratio after 3 and 12 months of treatment ; and ( 4 ) the smoothness index after 3 and 12 months of treatment . Similar calculations were also performed at the end of a final study month during which active treatment was withdrawn and placebo was substituted ( n = 164 ) . Results The smoothness index for systolic and diastolic ambulatory blood pressure computed after 3 months of treatment was more closely related to its corresponding values after 12 months of treatment than the trough : peak ratio values computed after the same time periods were ( r = 0.68 versus 0.38 for systolic and 0.68 versus 0.42 for diastolic blood pressure , respectively ) . The smoothness index showed an inverse correlation with the 24 h st and ard deviation of systolic and diastolic blood pressure ( r = −0.25 and −0.16 , P < 0.01 and < 0.05 , respectively , for 12 months of treatment ) , while the trough : peak ratio did not ( r = −0.01 to −0.12 , NS ) . A treatment-induced reduction in the left ventricular mass index was related to the smoothness index for systolic and diastolic blood pressure ( r = −0.35 and −0.32 , P < 0.001 with 12 months of treatment ) , but not to the corresponding trough : peak ratios . Conclusions The smoothness index identifies the occurrence of a balanced 24 h blood pressure reduction with treatment and correlates with the favourable effects of treatment on left ventricular hypertrophy better than the commonly used trough : peak ratio The antihypertensive activity of losartan potassium ( losartan , Cozaar ) , an angiotensin II receptor antagonist , was evaluated in a parallel 12-week , double-blind , placebo-controlled trial in hypertensive patients with mild-to-moderate hypertension . After a 4-week , single-blind , placebo lead-in period , which included monitoring of baseline variables , 366 patients with a group mean sitting diastolic blood pressure of 101 + /- 5 ( s.d . ) mmHg were assigned r and omly to one of three treatment groups : placebo , losartan 50 mg , or losartan 50 mg with the option to titrate to 100 mg after the first 6 weeks if the target sitting diastolic blood pressure ( < 90 mmHg ) was not reached . To assess the potential blood pressure response associated with the act of titration , patients in the placebo and losartan 50 mg treatment groups with a sitting diastolic blood pressure of > or = 90 mmHg at week 6 were mock titrated ( changed to a new tablet containing the same study medication and dose ) . Sitting diastolic blood pressure was also evaluated at the end of the trial during a 1-week off-drug period to assess for rebound hypertension . At week 6 , patients in the active-drug-treatment arms experienced significantly greater peak ( 6 h post-dose ) and trough ( 24 h post-dose ) reduction in systolic and diastolic sitting blood pressures compared with placebo ( p < or = 0.01 ) . Based on trough blood pressures at week 12 , active drug ( both arms ) was more effective than placebo in lowering sitting diastolic 
    Output:
    