title: The effect of fixed-dose combination of valsartan and amlodipine on nighttime blood pressure in patients with non-dipper hypertension.
abstract: OBJECTIVE
  Failure to decrease blood pressure (BP) during the night is associated with higher cardiovascular (CV) morbidity and mortality. There is strong evidence that fixed-dose combinations (FDCs) of antihypertensive agents are associated with significant improvement and non-significant adverse effects. The aim of the present study was to evaluate whether FDC affected nocturnal BP favorably in patients with uncontrolled, non-dipper hypertension (HT).
  
  
  METHODS
  All non-dipper hypertensives were either newly diagnosed with stage 2-3 HT or had HT uncontrolled with monotherapy. Patients (n=195) were consecutively assigned to 4 treatment groups: FDC of valsartan/amlodipine (160/5 mg), free-drug combination of valsartan 160 mg and amlodipine 5 mg, amlodipine 10 mg, and valsartan 320 mg. Ambulatory blood pressure monitoring (ABPM) was repeated at 4th and 8th week.
  
  
  RESULTS
  Average 24-h (24-hour) and nocturnal BP were similar among the groups at baseline evaluation, and had significantly decreased by the fourth week of treatment. However, BP continued to decrease only slightly between the 4th and 8th weeks in the valsartan and amlodipine monotherapy groups, but continued to decrease significantly in both combination groups. After 4 weeks, day-night BP difference and day-night BP % change were significantly elevated in the combination and valsartan groups. Between the 4th and 8th weeks, however, day-night BP difference and day-night BP % change continued to rise only in the FDC group, nearly reducing to baseline levels in the free-drug combination and valsartan groups. An additional 2.2 mmHg decrease was observed in the FDC group, compared to the free-drug combination group.
  
  
  CONCLUSIONS
  In non-dipper HT, FDC of valsartan and amlodipine improved diurnal-nocturnal ratio of BP and provided 24-h coverage.
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey. aydoganer@yahoo.com.
authors.forename: Doğan
authors.initials: D
authors.lastname: Erdoğan
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: İçli
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aksoy
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Salaheddin
authors.initials: S
authors.lastname: Akçay
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Habil
authors.initials: H
authors.lastname: Yücel
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Ersoy
authors.affiliation: Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özaydın
mesh_terms: D000328:Adult; D017311:Amlodipine / Q000008:administration & dosage* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000068756:Valsartan / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D017311:Amlodipine; D000068756:Valsartan