title: Efficacies of Controlling Morning Blood Pressure and Protecting the Kidneys by Treatment With Valsartan and Nifedipine CR or Valsartan and Amlodipine (MONICA Study).
abstract: BACKGROUND
  It is controversial whether a single-pill fixed-dose combination of angiotensin II type 1 receptor blocker and calcium channel blocker (CCB) is effective for all types of hypertension.
  
  
  METHODS
  Thirty-five patients with uncontrolled blood pressure (BP) under treatment with valsartan 80 mg/day or amlodipine 5 mg/day were enrolled. They were randomly divided into two treatment groups: a single-pill fixed-dose combination of valsartan 80 mg/day and amlodipine 5 mg/day in the morning (VA group), or valsartan 80 mg/day in the morning and nifedipine CR 20 mg/day at night (VN group), and treated for 16 weeks. If the patient did not reach the target office BP at 8 weeks, they received double doses of CCBs.
  
  
  RESULTS
  In the VN group, morning diastolic BP was significantly lower than the respective values in the VA group at 8 weeks. The percentage of patients who required a double dose of CCB in the VN group was significantly lower than that in the VA group. At 16 weeks, the BP levels in both groups were significantly reduced. Urinary albumin/creatinine at 16 weeks was significantly less than that at 0 weeks in the VN group.
  
  
  CONCLUSIONS
  Combination therapy with valsartan and nifedipine CR may help to control morning BP and protect the kidneys.
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan ; Tanaka Clinic, Kitakyusyu, Japan ; Mihagino Hospital, Kitakyusyu, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Tanaka
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Uehara
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hirano
authors.forename: Keijiro
authors.initials: K
authors.lastname: Saku
keywords: Albuminuria; Amlodipine; Combination therapy; Morning hypertension; Nifedipine CR