title: Evaluation of the Differences in the Effects of Antihypertensive Drugs on Blood Pressure Variability by 24-Hour Ambulatory Blood Pressure Monitoring in Chronic Cerebrovascular Disease.
abstract: BACKGROUND
  It has been suggested that antihypertensive drug therapy is attributable to the lower blood pressure variability, we investigated the effects of 4 classes of antihypertensives on the blood pressure variability; in addition, we also compared the effects among 4 calcium channel blockers.
  
  
  METHODS
  We measured the 24-hour blood pressure variability in 309 patients with a history of cerebrovascular disease treated with angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, β blocker, or calcium channel blocker.
  
  
  RESULTS
  The daytime blood pressure variability treated with β blockers (14.3 ± 3.1) was higher than that treated with an angiotensin receptor blockers (11.5 ± 3.1) or calcium channel blockers (12.6 ± 3.4) in patients with cerebrovascular disease (P < .05). In the analysis of the patient distribution of blood pressure variability, patients receiving β blockers occurred more frequently in the higher blood pressure variability (P = .0023). Treatment with angiotensin receptor blockers and cilnidipine, which blocks N-type calcium channels, was shown to be more frequently associated with the lower blood pressure variability (P = .0202 and .0467). The mean blood pressure of patients grouped by distribution of blood pressure variability was found to be independent to blood pressure variability, for any of the antihypertensive drugs or calcium channel blockers examined.
  
  
  CONCLUSIONS
  From the results, it is suggested that angiotensin receptor blocker and calcium channel blockers rather than β blockers may be more favorable for blood pressure management in patients with cerebrovascular disease. Among the calcium channel blockers, cilnidipine may be more favorable than other calcium channel blockers.
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan; School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Nishioka
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kinoshita
authors.affiliation: Information Technology Center, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Shiibashi
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimazu
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nakazato
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Naotoshi
authors.initials: N
authors.lastname: Tamura
authors.affiliation: Department of Neurology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan. Electronic address: arakin@saitama-med.ac.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Araki
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D007004:Hypoglycemic Agents
keywords: Hypertension; antihypertensive drugs; blood pressure variability; cerebrovascular disease(CVD); cilnidipine; β-blocker