Beneficial effect of calcium channel blockers on home blood pressure variability in the morning in patients with type 2 diabetes.
OBJECTIVE
Recent studies have shown the association between blood pressure variability and cardiovascular events. The present study was designed to investigate the relationship between antihypertensive drug class and home blood pressure variability in patients with type 2 diabetes.


METHODS
We compared home blood pressure variability among patients treated with calcium channel blockers (n = 44), with angiotensin II receptor blockers and/or angiotensin-converting enzyme inhibitors (n = 159), and with calcium channel blockers combined with angiotensin II receptor blockers and/or angiotensin-converting enzyme inhibitors (n = 183). Next, we analyzed the effect of calcium channel blockers on morning blood pressure variability using multiple linear regression analysis.


RESULTS
Coefficient variation of morning systolic blood pressure in patients treated with calcium channel blockers was significantly lower than that in patients treated with angiotensin II receptor blockers and/or angiotensin-converting enzyme inhibitors (P = 0.036). Multivariate linear regression analyses showed that treatment with calcium channel blockers was significantly correlated with coefficient variation of morning systolic blood pressure (β = -0.264, P = 0.001).


CONCLUSIONS
The present study implies a possibility for validity on selecting calcium channel blockers in hypertensive patients with type 2 diabetes to reduce home blood pressure variability.
Department of Endocrinology and Metabolism Kyoto Prefectural University of Medicine Graduate School of Medical Science Japan.
Emi
E
Ushigome
Department of Endocrinology and Metabolism Kyoto Prefectural University of Medicine Graduate School of Medical Science Japan.
Michiaki
M
Fukui
Immunology Frontier Research Center at Osaka University Japan.
Masahide
M
Hamaguchi
Kyoto First Red Cross Hospital Kyoto Japan.
Toru
T
Tanaka
Kyoto Second Red Cross Hospital Japan.
Haruhiko
H
Atsuta
Osaka General Hospital of West Japan Railway Company Osaka Japan.
Masayoshi
M
Ohnishi
Social Insurance Kyoto Hospital Kyoto.
Yohei
Y
Oda
Department of Endocrinology and Metabolism Kyoto Prefectural University of Medicine Graduate School of Medical Science Japan.
Masahiro
M
Yamazaki
Department of Endocrinology and Metabolism Kyoto Prefectural University of Medicine Graduate School of Medical Science Japan.
Goji
G
Hasegawa
Department of Endocrinology and Metabolism Kyoto Prefectural University of Medicine Graduate School of Medical Science Japan.
Naoto
N
Nakamura
Blood pressure variability; Home blood pressure monitoring; Type 2 diabetes mellitus