title: Preferable effects of olmesartan/calcium channel blocker to olmesartan/diuretic on blood pressure variability in very elderly hypertension: COLM study subanalysis.
abstract: OBJECTIVE
  The aims of this subanalysis of the COLM trial [NCT00454662] were to compare visit-to-visit variability (VVV) of blood pressure (BP) between age groups and between two treatment combinations, that is, the angiotensin II receptor blocker, olmesartan combined with a calcium channel blocker (CCB), or a diuretic and to investigate the effect of VVV of BP on cardiovascular events in elderly hypertensive patients.
  
  
  METHODS
  Hypertensive patients ages 65-84 years with a history of and/or risk factors for cardiovascular disease were randomized to receive treatment with olmesartan along with either a CCB or a diuretic for at least 3 years. This subanalysis comprised 4876 patients who had their office BP measured at least three occasions (median nine occasions) during the follow-up period. VVV of BP was defined by several metrics including the within-individual standard deviation of every visit during the follow-up period.
  
  
  RESULTS
  VVV of SBP was larger in the very elderly group (75-84 years) than in the elderly group (65-74 years). VVV of SBP was smaller in the olmesartan along with CCB group than in the olmesartan along with diuretic group, especially in very elderly patients and also isolated systolic hypertensive patients. The incidence rate of primary endpoint increased along with an increment in the SD of SBP in all of the age and treatment groups.
  
  
  CONCLUSIONS
  VVV of SBP may mediate the preferable effect of combination of angiotensin II receptor blocker along with CCB on cardiovascular events in the very elderly and also isolated systolic hypertensive patients.
authors.affiliation: aOsaka University Graduate School of Medicine, Osaka bMorinomiya University of Medical Sciences, Osaka cKeio University, Tokyo dKyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto eShin-oyama City Hospital, Tochigi fSaitama Medical University, Saitama gEhime University Graduate School of Medicine, Ehime hTokyo Medical University, Tokyo iAsahi Rousai Hospital, Aichi, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.forename: Takao
authors.initials: T
authors.lastname: Saruta
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kawai
authors.forename: Ikuo
authors.initials: I
authors.lastname: Saito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Katayama
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
authors.forename: Masato
authors.initials: M
authors.lastname: Odawara
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
authors.forename: Genjiroh
authors.initials: G
authors.lastname: Kimura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D004232:Diuretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D012307:Risk Factors; D013777:Tetrazoles / Q000627:therapeutic use*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan