title: Benefit of losartan/hydrochlorothiazide-fixed dose combination treatment for isolated morning hypertension: The MAPPY study.
abstract: Morning hypertension is an established risk factor for cardiovascular events. In the Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy (MAPPY) study, a 50-mg losartan/12.5-mg hydrochlorothiazide combination (Los/HCTZ) lowered morning blood pressure (BP) more effectively than 100-mg losartan (High-Los) in treated hypertensive patients with morning hypertension. The aim of this MAPPY study sub-analysis was to determine whether Los/HCTZ was effective for controlling isolated morning hypertension (morning BP ≥ 135/85 mmHg and evening BP < 135/85 mmHg), sustained hypertension (morning and evening BP ≥ 135/85 mmHg), or both. Of the 110 patients studied, 25 (22.7%) had isolated morning hypertension, and 85 (77.3%) had sustained hypertension at baseline. After 3-month treatment, isolated morning hypertension developed into controlled hypertension (morning and evening BP < 135/85 mmHg) in 9 of 11 Los/HCTZ patients (81.8%) and 3 of 14 High-Los patients (21.4%) (p = 0.003, chi-square test). Sustained hypertension developed into controlled hypertension in 21 of 44 Los/HCTZ patients (47.7%) and 13 of 41 High-Los patients (31.7%)(NS). The rates of achievement of SBP < 135 mmHg both in the morning and evening were: 81.8% and 21.4% in Los/HCTZ- and High-Los-treated isolated morning hypertension (p = 0.003), respectively; and 61.4% and 36.6% in Los/HCTX- and High-Los-treated sustained hypertension (p = 0.022), respectively. In conclusion, Los/HCTZ was effective for controlling both types of morning hypertension, especially isolated morning hypertension. Los/HCTZ was superior to High-Los in treating both types of morning hypertension.
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Hisashi
authors: H
authors: Kai
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Tamenobu
authors: T
authors: Ueda
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Hiroki
authors: H
authors: Uchiwa
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Yoshiko
authors: Y
authors: Iwamoto
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Yuji
authors: Y
authors: Aoki
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Takahiro
authors: T
authors: Anegawa
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .|b Department of Cerebrovascular Disease , St. Mary's Hospital , Kurume , Japan , and.
authors: Kenji
authors: K
authors: Fukuda
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .
authors: Yoshihiro
authors: Y
authors: Fukumoto
authors: a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan .|c International University of Health and Welfare, Fukuoka Sannno Hospital , Fukuoka , Japan.
authors: Tsutomu
authors: T
authors: Imaizumi
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; C505809:hydrochlorothiazide, losartan drug combination; D006852:Hydrochlorothiazide; D019808:Losartan
keywords: Angiotensin receptor blockers; combination therapy; diuretics; morning hypertension; treatment