Sleep-predominant lowering of ambulatory blood pressure by bedtime inhalation of a novel muscarinic M3 receptor antagonist: a new "bronchoantihypertensive" strategy targeting the lung in hypertension with chronic obstructive pulmonary disease.
Bedtime inhalation of a novel muscarinic M3 receptor antagonist markedly lowered ambulatory blood pressure (ABP), predominantly during sleep, in a chronic obstructive pulmonary disease (COPD) patient with masked nocturnal hypertension. This is the first case demonstrating that a bronchodilator significantly lowered ABP in a COPD patient with hypertension. This case suggests that bronchodilator therapy may have potential as a new antihypertensive strategy targeting the lung in hypertensive patients with impaired lung function. This "bronchoantihypertensive" therapy seems to be more effective for reducing sleep blood pressure in hypertensive patients with COPD and sleep hypoventilatory/hypoxemic syndromes.
Kario
Kazuomi
K
Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan. kkario@jichi.ac.jp
Uno
Hideyuki
H
Shimada
Kazuyuki
K
D000280:Administration, Inhalation; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002940:Circadian Rhythm; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D043587:Receptor, Muscarinic M3 / Q000037:antagonists & inhibitors*; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D012890:Sleep; D000069447:Tiotropium Bromide
D000959:Antihypertensive Agents; D001993:Bronchodilator Agents; D043587:Receptor, Muscarinic M3; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide