title: Different chronotherapeutic effects of valsartan and olmesartan in non-dipper hypertensive patients during valsartan treatment at morning.
abstract: This study was undertaken to evaluate the differences in chronotherapeutic effects of angiotensin-II receptor blockers, valsartan and olmesartan in hypertensive patients with non-dipper blood pressure (BP) pattern during valsartan at morning. Ninety four patients were enrolled, and 40 patients were judged to be non-dippers. In these patients, same dose of valsartan was changed to evening (Val-E, n = 12), or olmesartan (equivalent dose of valsartan) was given at morning (Olm-M, n = 13) or evening (Olm-E, n = 15) for 4 months. BP decreased during sleep and increased during waking hours in Val-E group. In Olm-M and Olm-E groups, BP decreased during sleep and waking hours. Percent reduction in BP at night-time compared to BP at waking hours significantly increased after changing the dose regimen in each group. Serum creatinine decreased and estimated glomerular filtration rate (eGFR) elevated in Olm-M and Olm-E, but not Val-E groups. Positive correlation between systolic BP (SBP) during sleep and serum creatinine, and negative correlation between SBP during sleep and eGFR were detected. These data suggest that dipper BP pattern could be obtained by chronotherapeutic approach using valsartan and olmesartan in non-dipper patients with valsartan at morning. Morning and evening olmesartan, but not evening valsartan improved renal function in these patients.
authors.affiliation: Department of Clinical Pharmacology, Jichi Medical University, Tochigi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ushijima
authors.affiliation: Matsunaga Cardiology Hospital, Oita, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakashima
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shiga
authors.affiliation: Kasaoka Dai-ichi Hospital, Okayama, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.affiliation: Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
authors.affiliation: Division of Nephrology, International University of Health and Welfare, Tochigi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ioka
authors.affiliation: Department of Clinical Pharmacology, Jichi Medical University, Tochigi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.affiliation: Department of Clinical Pharmacology, Jichi Medical University, Tochigi, Japan. Electronic address: akiofuji@jichi.ac.jp.
authors.forename: Akio
authors.initials: A
authors.lastname: Fujimura
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D055870:Drug Chronotherapy; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000068756:Valsartan / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D007093:Imidazoles; D013777:Tetrazoles; D000068756:Valsartan; C437965:olmesartan; D003404:Creatinine
keywords: ABPM; Angiotensin-II receptor blocker; Chronotherapy; Non-dipper; Renal function