Different chronotherapeutic effects of valsartan and olmesartan in non-dipper hypertensive patients during valsartan treatment at morning

Ushijima, Kazuo; Nakashima, Hitoshi; Shiga, Tsuyoshi; Harada, Kazuhiro; Ishikawa, Shizukiyo; Ioka, Takashi; Ando, Hitoshi; Fujimura, Akio

doi:10.1016/j.jphs.2014.09.004

Cited by 15 publications

(8 citation statements)

References 22 publications

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“…Calcium antagonists, particularly amlodipine, increase nocturnal urine volume by selectively dilating renal afferent arterioles. Olmesartan normalizes non‐dipping blood pressure . It was reported that taking an α1 receptor blocker at night significantly decreased nocturnal blood pressure in non‐dippers and risers .…”

Section: Discussionmentioning

confidence: 99%

Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Takayama

Omori

Iwasaki

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Takayama

Omori

Iwasaki

et al. 2018

LUTS

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“…The group has presented similar findings related to olmesartan (ARB) which has a terminal half-life of ~13-h (52, 100). In contrast, Ushijima et al (101), report no additional benefit of taking olmesartan in the evening compared to the morning. Moreover, the study confirms decreased BP during sleep when valsartan (ARB with terminal half-life of 6–9 hours) is taken at bedtime compared to the morning (100, 101).…”

Section: Resultsmentioning

confidence: 95%

“…In contrast, Ushijima et al (101), report no additional benefit of taking olmesartan in the evening compared to the morning. Moreover, the study confirms decreased BP during sleep when valsartan (ARB with terminal half-life of 6–9 hours) is taken at bedtime compared to the morning (100, 101). Thus, it is surprising that Zappe et al conclude that once daily administration of valsartan resulted in similar 24-h BP control regardless of dosing time and when compared to administration of a long-acting ACEI taken in the morning (102).…”

Section: Resultsmentioning

confidence: 95%

Chronotherapy for Hypertension

et al. 2018

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Given the emerging knowledge that circadian rhythmicity exists in every cell and all organ systems, there is increasing interest in the possible benefits of chronotherapy for many diseases. There is a well-documented 24-h pattern of blood pressure with a morning surge that may contribute to the observed morning increase in adverse cardiovascular events. Historically, antihypertensive therapy involves morning doses, usually aimed at reducing daytime blood pressure surges, but an absence of nocturnal dipping blood pressure is also associated with increased cardiovascular risk. To more effectively reduce nocturnal blood pressure and still counteract the morning surge in blood pressure, a number of studies have examined moving one or more antihypertensives from morning to bedtime dosing. More recently, such studies of chronotherapy have studied comorbid populations including obstructive sleep apnea, chronic kidney disease, or diabetes. Here, we summarize major findings from recent research in this area (2013-2017). In general, nighttime administration of antihypertensives improved overall 24-h blood pressure profiles regardless of disease comorbidity. However, inconsistencies between studies suggest a need for more prospective randomized controlled trials with sufficient statistical power. In addition, experimental studies to ascertain mechanisms by which chronotherapy is beneficial could aid drug design and guidelines for timed administration.

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“…20 Finally, reducing morning BP surge <45 mmHg, the third step for the perfect BP control, is important for the prevention of cardiovascular events. 21 Recently, a study comparing the effect of valsartan and olmesartan in non-dipper hypertensive patients, 22 showed that evening administration of valsartan and olmesartan was effective for recovering dipping pattern, but the study was focused on the chronotherapeutic effects of valsartan and olmesartan and their comparative efficacy. There is still little data on comparative efficacy of night-time ABP-lowering effect among ARBs.…”

Section: Discussionmentioning

confidence: 99%

<p>Effect of Fimasartan versus Valsartan and Olmesartan on Office and Ambulatory Blood Pressure in Korean Patients with Mild-to-Moderate Essential Hypertension: A Randomized, Double-Blind, Active Control, Three-Parallel Group, Forced Titration, Multicenter, Phase IV Study (Fimasartan Achieving Systolic Blood Pressure Target (FAST) Study)</p>

Chung¹,

Ihm²,

Jang³

et al. 2020

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Purpose: Head-to-head comparison of the blood pressure (BP) lowering effect of fimasartan versus valsartan, with olmesartan as a reference, on office blood pressure and ambulatory BP. Patients and Methods: Of the 369 randomly assigned patients in this study, 365 hypertensive patients were referred as the full analysis set and divided into 3 groups with a 3:3:1 ratio (fimasartan group: 155, valsartan group: 157, olmesartan group: 53). After the 2-week single-blind placebo run-in period, initial standard doses of 60-mg fimasartan, 80-mg valsartan, and 10-mg olmesartan were administered for 2 weeks, then forcibly up-titrated higher doses (fimasartan 120 mg, valsartan 160 mg, olmesartan 20 mg) were given for 4 weeks. ABP was measured before and after the 6-week treatment. Primary endpoint was reduction of sitting office systolic BP (SiSBP) of fimasartan compared to valsartan after 6 weeks. Secondary endpoints were reduction of sitting office diastolic BP (SiDBP) and 24 hrs, daytime, and night-time mean systolic and diastolic ABP (ASBP, ADBP) after 6 weeks. Results: Patients' mean age was 58.34±7.68 years, and 289 patients were male (79.18%). After the 6-week treatment, SiSBP reduction of fimasartan and valsartan were −16.26±15.07 and −12.81±13.87 (p=0.0298) and SiDBP were −7.63±9.67 and −5.14±8.52 (p=0.0211). Reductions in 24 hrs mean ASBP were −15.22±13.33 and −9.45±12.37 (p=0.0009), and ADBPs were −8.74±7.55 and −5.98±7.85 (p=0.0140). Reductions of night-time ASBPs were −16.80±15.81 and −10.32±14.88 (p=0.0012), and those of night-time ADBPs were −8.89 ±9.93 and −5.55±9.70 (p=0.0152). Reduction of BP in olmesartan group did not demonstrate significant difference with fimasartan group in all end-points. Conclusion: Fimasartan 120-mg treatment demonstrated superior efficacy in reduction of SiSBP, SiDBP, and 24 hrs ASBP and ADBP compared to valsartan 160 mg. Reduction of night-time ASBP from baseline was largest in fimasartan group, suggesting that fimasartan may be effective for recovering dipping pattern. NCT number: NCT02495324 (Fimasartan Achieving SBP Target (FAST) study).

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Different chronotherapeutic effects of valsartan and olmesartan in non-dipper hypertensive patients during valsartan treatment at morning

Cited by 15 publications

References 22 publications

Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Chronotherapy for Hypertension

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