Administration-Time-Dependent Effects of Diltiazem on the 24-Hour Blood Pressure Profile of Essential Hypertension Patients

Kohno, Isao; Iwasaki, Hiroshi; Okutani, Mitsuaki; Mochizuki, Yasuaki; Sano, Soichi; Satoh, Yoshioki; Ishihara, Tsukasa; Ishii, Hiroyuki; Mukaiyama, Shigeo; Ijiri, Hiroshi; Komori, Sadayoshi; Tamura, Kohji

doi:10.3109/07420529709040543

Cited by 33 publications

(23 citation statements)

References 17 publications

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“…9,16 Previous studies have investigated the chronotherapeutics of several medicines, including diuretics, angiotensin converting enzyme inhibitors and AT 1 receptor blockers and CCBs. [10][11][12][13] Studied CCBs include amlodipine, 10,17 diltiazem, 11 and cilnidipine. 18 Portaluppi et al 19 explored the relative advantage of evening vs. morning once-a-day treatment with a conventional sustained-release isradipine formulation in non-dipper hypertensive patients with chronic renal failure and found that an evening dosing schedule best reduces and normalizes nocturnal SBP and DBP.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated differing effects of angiotensin-converting enzyme inhibitors, CCBs and diuretics when administered in the morning vs. the evening. [10][11][12][13] However, rarely has the time of drug administration been a specific investigative focus for fixed combinations of anti-hypertensive medications. This study compared, by 24-h ambulatory blood pressure monitoring (ABPM), the anti-hypertensive efficacy of the administration of a fixed combination of amlodipine (a CCB) and a diuretic (hydrochlorothiazide) in a single pill (amlodipine complex) in the morning vs. the evening over a 12-week period.…”

Section: Introductionmentioning

confidence: 99%

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Fixed-combination of amlodipine and diuretic chronotherapy in the treatment of essential hypertension: improved blood pressure control with bedtime dosing—a multicenter, open-label randomized study

et al. 2011

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Previous studies have demonstrated that individual anti-hypertension medications have different effects when administered in the morning vs. the evening. However, the impact of administration timing on fixed combinations of anti-hypertensive medications on blood pressure control is still unknown. In the present study, we examined the administration time-dependent effects of a fixed combination of amlodipine and diuretics (amlodipine complex) on blood pressure in hypertensive subjects. Eighty patients from Chongqing City were enrolled in this study. Subjects were randomly assigned to receive a single pill (amlodipine complex, each tablet containing amlodipine 5 mg and hydrochlorothiazide 25 mg), either in the morning (0800 hours, n¼40) or at bedtime (2200 hours, n¼40). Blood pressure was measured by ambulatory monitoring every 20 min during the day and every 30 min at night for 24 consecutive hours before and after the 12 weeks of treatment. Following treatment, the 24-h mean systolic and diastolic blood pressures were reduced significantly in both the morning and bedtime groups. However, the morning blood pressure surge was reduced to a greater degree in the bedtime group. In addition, the nocturnal blood pressure and the 24 h mean blood pressure were lower in the bedtime group. More patients converted from having a non-dipper to dipper blood pressure in the bedtime group. These findings confirm that amlodipine complexes have different efficiencies depending on treatment time. Administration of amlodipine complexes at bedtime could optimize the anti-hypertensive effect by augmenting blood pressure-lowering effects, increasing the diurnal/nocturnal ratio of blood pressure, normalizing the blood pressure pattern and minimizing the morning blood pressure surge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fixed-combination of amlodipine and diuretic chronotherapy in the treatment of essential hypertension: improved blood pressure control with bedtime dosing—a multicenter, open-label randomized study

et al. 2011

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“…In hypertensive dippers, the mean 48-h BP was reduced with both morning and evening doses. In non-dippers, the systolic BP decreased at night with both doses, but the extent of the nocturnal reduction in systolic BP was greater after morning therapy compared with the evening dose [42].…”

Section: Implications Of Nocturnal Hypertension: Is There a Role For mentioning

confidence: 82%

“…ACE inhibitors, by contrast, have been shown to be more effective in 24-hour BP control when administered in the evening in some studies. The difference in the antihypertensive effect of morning versus evening doses of imidapril was studied in hypertensive dippers and non-dippers [42]. In hypertensive dippers, the mean 48-h BP was reduced with both morning and evening doses.…”

Section: Implications Of Nocturnal Hypertension: Is There a Role For mentioning

confidence: 99%

Nocturnal hypertension: Will control of nighttime blood pressure prevent progression of diabetic renal disease?

Moorthi

Hogan

Lurbe

et al. 2004

Current Science Inc

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Patients with type 1 and 2 diabetes and nephropathy frequently have a blunted fall in nighttime arterial blood pressure. This abnormality is already seen in subjects with type 1 diabetes who are in the microalbuminuric phase of the disease, and we have also shown that an increase in nighttime systolic blood pressure precedes the development of microalbuminuria. These studies suggest that nocturnal hypertension may be an important early predictor of diabetic nephropathy. Various drugs have different effects on nocturnal blood pressure, and chronotherapy may be key in determining clinical outcomes. There is a compelling need for studies showing that treating nocturnal hypertension in diabetes can prevent renal disease progression.

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“…For chronopharmacodynamics of calcium channel blockers (CCB) several trials have investigated the differential effects of morning vs. evening administration of CCB, including amlodipine, cilnidipine, diltiazem, isradipine, nifedipine, nisoldipine, and nitrendipine in diurnally active subjects [63][64][65][66][67][68][69][70][71][72][73][74][75] . A sustained-release formulation of diltiazem was found to be more effective in controlling the 24-hour BP mean when administered at night, while also reducing the diurnal/nocturnal BP ratio towards a more nondipper profile.…”

Section: Calcium Channel Blockersmentioning

confidence: 99%

Chronobiology and Chronotherapy of Hypertension – A Review

Latha¹,

Uhumwangho²,

Sunil³

et al. 2011

Int J Health Res

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an online international journal allowing free unlimited access to abstract and full-text of published articles. The journal is devoted to the promotion of health sciences and related disciplines (including medicine, pharmacy, nursing, biotechnology, cell and molecular biology, and related engineering fields). It seeks particularly (but not exclusively) to encourage multidisciplinary research and collaboration among scientists, the industry and the healthcare professionals. It will also provide an international forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. The journal welcomes original research papers, reviews and case reports on current topics of special interest and relevance. All manuscripts will be subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication) will be published without delay. The maximum length of manuscripts should normally be 10,000 words (20 single-spaced typewritten pages) for review, 6,000 words for research articles, 3,000 for technical notes, case reports, commentaries and short communications. Submission of Manuscript:The International Journal of Health Research uses a journal management software to allow authors track the changes to their submission. All manuscripts must be in MS Word and in English and should be submitted online at http://www.ijhr.org. Authors who do not want to submit online or cannot submit online should send their manuscript by e-mail attachment (in single file) to the editorial office below. Submission of a manuscript is an indication that the content has not been published or under consideration for publication elsewhere. Authors may submit the names of expert reviewers or those they do not want to review their papers. Enquirie Review Article Chronobiology and Chronotherapy of Hypertension -A Review AbstractHypertension occurs in over 90% of all patients with cardiovascular disease (CVD) in the United States and it is a major risk factor for end-organ damage, CVD and death. In the treatment of hypertension, investigation of chronobiology, chronopharmacology and chronotherapy began a few decades ago. Studies over the last decade have revealed that blood pressure (BP) and CVD are influenced by our behaviour such as what we eat and even conditioned by the time of day. Also, the ability of the night: day ratio of systolic BP predicts the risk for cardiovascular events more accurately compared with office BP measured only at once. Evidence clearly points to the fact that nocturnal BP is indeed the BP as it is most consistently correlated with prediction of cardiovascular risk and provides more close surveillance of safety. Circadian rhythm is a significant input into the regulation of BP. Hence, a circadian disorder such as hypertension requires chronopharmacotherapy. However, different medications have been studied for their chronopharmacology and potential chronotherapy. This article reviews the chronobiology of hypertension, and the ...

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Administration-Time-Dependent Effects of Diltiazem on the 24-Hour Blood Pressure Profile of Essential Hypertension Patients

Cited by 33 publications

References 17 publications

Fixed-combination of amlodipine and diuretic chronotherapy in the treatment of essential hypertension: improved blood pressure control with bedtime dosing—a multicenter, open-label randomized study

Fixed-combination of amlodipine and diuretic chronotherapy in the treatment of essential hypertension: improved blood pressure control with bedtime dosing—a multicenter, open-label randomized study

Nocturnal hypertension: Will control of nighttime blood pressure prevent progression of diabetic renal disease?

Chronobiology and Chronotherapy of Hypertension – A Review

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