title: Comparative effect of candesartan and amlodipine, and effect of switching from valsartan, losartan, telmisartan and olmesartan to candesartan, on early morning hypertension and heart rate.
abstract: Early morning hypertension and a high heart rate are risk factors for cardiovascular disease. The DOHSAM study was designed to evaluate the effect of candesartan on early morning blood pressure (BP) and heart rate in hypertensives. We used a prospective, randomized, open-label design. Protocol 1: Patients with early morning BP more than 135/85 mmHg who were not on any antihypertensive drug or on candesartan were given amlodipine 2.5 mg/day (amlodipine group, n = 22) or added candesartan 4 mg/day (candesartan group, n = 36). Candesartan or amlodipine was added when BP did not fall lower than 135/85 mmHg. Protocol 2: Early morning hypertensives who were on other angiotensin receptor blockers (ARBs) (n = 50) such as valsartan, losartan, telmisartan and olmesartan were switched to candesartan. Early morning BP significantly decreased in the candesartan group compared with the amlodipine group 9 and 12 months after treatment. Switching other ARBs except for olmesartan to candesartan significantly decreased early morning systolic and diastolic BP 3, 6, 9 and 12 months after treatment. Heart rate in the office significantly decreased by switching to candesartan 6, 9 and 12 months after treatment. In conclusion, candesartan significantly decreased early morning hypertension more than amlodipine or other ARBs except olmesartan in early morning hypertensives.
authors: Department of Cardiology, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 5011194, Japan. minatos@gifu-u.ac.jp
authors: Shinya
authors: S
authors: Minatoguchi
authors: Takuma
authors: T
authors: Aoyama
authors: Naoki
authors: N
authors: Kawai
authors: Mitsunori
authors: M
authors: Iwasa
authors: Masayuki
authors: M
authors: Oda
authors: Keiji
authors: K
authors: Kida
authors: Syojiro
authors: S
authors: Kojima
authors: Naomi
authors: N
authors: Goto
authors: Masahiro
authors: M
authors: Goto
authors: Fusayoshi
authors: F
authors: Sugishita
authors: Kuniyuki
authors: K
authors: Takai
authors: Ryuhei
authors: R
authors: Tanaka
authors: Keiji
authors: K
authors: Hiei
authors: Taro
authors: T
authors: Minagawa
authors: Noritaka
authors: N
authors: Yamamoto
authors: Ikuo
authors: I
authors: Watanabe
authors: Takao
authors: T
authors: Yasue
authors: Hiroshi
authors: H
authors: Kobayashi
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001562:Benzimidazoles / Q000494:pharmacology*; D001565:Benzoates / Q000494:pharmacology*; D001713:Biphenyl Compounds; D057915:Drug Substitution; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007093:Imidazoles / Q000494:pharmacology*; D019808:Losartan / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077333:Telmisartan; D013777:Tetrazoles / Q000494:pharmacology*; D014633:Valine / Q000031:analogs & derivatives* / Q000494:pharmacology; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D007093:Imidazoles; D013777:Tetrazoles; D017311:Amlodipine; D000068756:Valsartan; C437965:olmesartan; D014633:Valine; D019808:Losartan; C081643:candesartan; D000077333:Telmisartan