title: Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation.
abstract: It has long been thought that there is a close association between hypertension and atrial fibrillation (AF). However, the efficacy of an angiotensin II receptor blocker for the prevention of organ damage in hypertensive individuals with AF is still controversial. The present study was a multicentered, prospective, randomized, open-label clinical trial investigating the differences in the effect of treatment with telmisartan/amlodipine combination tablets on blood pressure (BP) levels and BP variability between morning and bedtime administration in hypertensive patients with paroxysmal AF, using ambulatory BP monitoring (ABPM) and home BP. With this treatment, the patients' 24-hour BP, nighttime BP, preawake BP, and morning BP shown by ABPM were significantly reduced, and the antihypertensive effects were similar regardless of the timing of the drug administration. The standard deviation of day-by-day home systolic BP and the maximum home systolic BP were also significantly reduced, and these effects were similar regardless of the treatment timing. The N-terminal pro-brain natriuretic peptide level was significantly decreased only in the bedtime administration group. A larger study will demonstrate whether the bedtime administration of telmisartan/amlodipine combination tablets maximizes the risk-lowering effect against AF recurrence in paroxysmal AF hypertensive patients.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan. kkario@jichi.ac.jp.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.affiliation: Uchiyama Clinic, Niigata, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchiyama
authors.affiliation: Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Okazaki
authors.affiliation: Noshiro Clinic, Tochigi, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Noshiro
authors.affiliation: Japanese Red Cross Koga Hospital, Ibaraki, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Aoki
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mizuno
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Matsumoto
mesh_terms: D017311:Amlodipine / Q000008:administration & dosage*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000378:metabolism / Q000517:prevention & control*; D001562:Benzimidazoles / Q000008:administration & dosage*; D001565:Benzoates / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D002940:Circadian Rhythm; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D011446:Prospective Studies; D000077333:Telmisartan; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D002121:Calcium Channel Blockers; D004338:Drug Combinations; C548840:telmisartan amlodipine combination; D020097:Natriuretic Peptide, Brain; D017311:Amlodipine; D000077333:Telmisartan