Effects of Bedtime vs. Morning Administration of the Long-Acting Lipophilic Angiotensin-Converting Enzyme Inhibitor Trandolapril on Morning Blood Pressure in Hypertensive Patients

Kuroda, Takeshi; Kario, Kazuomi; Hashimoto, Toru; Nomura, Yutaro; Saito, Yoshihiro; Mito, Hideaki; Shimada, Kazuyuki

doi:10.1291/hypres.27.15

Cited by 62 publications

(32 citation statements)

References 44 publications

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“…In another study, the bedtime administration of trandolapril also significantly reduced morning blood pressure levels. 29 Besides the circadian blood pressure pattern, increasing numbers of studies indicate that cardiovascular events occur more frequently in the morning, and that this phenomenon may be related to the morning blood pressure surge. 30 An anti-hypertensive medication that reduces the morning blood pressure surge would be useful in the prevention of cardiovascular events in hypertensive patients.…”

Section: Discussionmentioning

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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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%

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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“…Recently, because morning blood pressure surge was linked to adverse cardiovascular events (32), several investigators (33,34) proposed that these drugs be administered at bedtime rather than in the morning in order to reduce the early-morning surge. It remains to be seen whether SUM is accurate with such a medication schedule, or whether it is appropriate for patients with severe target organ damage including the kidney and patients in the accelerated phase of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Spot Urine Method in Evaluating Daily Salt Intake in Hypertensive Patients Taking Oral Antihypertensive Drugs

et al. 2006

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Kawasaki et al. developed a spot urine method (SUM) for evaluating daily salt intake using one pre-breakfast sample obtained after initial voiding upon arising. Their subjects were healthy persons who were not taking any regular medications. To determine whether SUM can be successfully used for patients taking antihypertensive drugs, we estimated daily salt intake in 73 hypertensive patients by SUM and by a food consumption method (FCM) when they were at home, and also by SUM in the hospital with a defined intake of 7 g of sodium chloride (NaCl). Forty-one patients took oral antihypertensive medications once daily, while 32 patients took none. Mean daily salt intakes by SUM during admission were 7-8 g of NaCl in both groups (95% confidence intervals: 5.0-10.6 g in the medication group; 5.2-11.1 g in the no-medication group), which corresponded well to the diet. In contrast, ambulatory daily salt intake by SUM varied widely (95% confidence intervals: 5.5-20.7 g in the medication group; 7.6-22.8 g in the no-medication group). However, the

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“…However, there is a possibility that the effectiveness of this kind of administration is inadequate for some treated hypertensives and that morning hypertension cannot be avoided. Therefore, it is expected that the home blood pressure value will become a powerful parameter that can be used to determine the appropriate antihypertensive drug(s) with respect to the best duration for each patient (20) and the most effective administration schedule (21).…”

Section: Discussionmentioning

confidence: 99%

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

2005

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To assess home blood pressure status in a Japanese urban population, we analyzed home blood pressure values in normotensive subjects determined by casual blood pressure (<140/90 mmHg), hypertensive subjects without medication (≥140/90 mmHg) and treated hypertensive patients. The subjects (468 male, 232 female; mean age 41 years old) were recruited from a company located in Tokyo. Home blood pressure was measured with a semi-automatic device (Omron HEM-759P). Subjects were instructed to perform triplicate morning and evening measurements on 7 consecutive days. In the treated hypertensive group (n =70), there was a significant difference between morning (139 ± 12/88 ± 9 mmHg) and evening (130 ± 12/79 ± 8 mmHg) home blood pressure. In the normotensive group (n =558), however, only the diastolic blood pressure (DBP) component of the home blood pressure was significantly different between morning (115 ± 13/72 ± 9 mmHg) and evening (114 ± 12/68 ± 8 mmHg). In the nontreated hypertensive group (n =72), casual blood pressure (145±14/92 ± 9 mmHg) was higher than morning (138 ± 16/89 ± 11 mmHg) and evening (134 ± 16/83 ± 11 mmHg) home blood pressure, but no difference was seen between morning and evening systolic blood pressure (SBP). According to the reference value of the Japanese Society of Hypertension 2004 (SBP ≥135 mmHg and/or DBP ≥85 mmHg), 7.2% (systolic) and 8.7% (diastolic) of subjects in the normotensive group were classified as hypertensive by home blood pressure. Casual blood pressure in the treated hypertensive group was normal in 64.3% for SBP and 70.0% for DBP. However, their morning SBP (32.9%), morning DBP (40.0%), evening SBP (10.0%), and evening DBP (17.1%) were classified as hypertensive by home blood pressure. Furthermore, patients who were taking antihypertensive drug(s) only in the morning (n =52) showed higher morning SBP (6 mmHg, p =0.086) and morning DBP (6 mmHg, p =0.005) than patients taking drug(s) by other administration schedules (n =18), but no difference in evening home blood pressure was observed. In conclusion, a proportion of the subjects defined as normotensive by casual blood pressure Hypertens Res Vol. 28, No. 6 (2005) IntroductionSelf-measurement of blood pressure at home has developed enormously in recent years (1) and is useful in raising people's concern about hypertension. In the medical management of hypertensive patients, home blood pressure measurement raises their knowledge and consciousness of hypertension, and has become one of the important means of motivating patients to take an active, positive role in their medical treatment. However, there have been few reports on the status of home blood pressure values in normotensives and hypertensive patients (2, 3).It has been reported that only a small proportion of patients on antihypertensive drugs have well controlled blood pressure (4−6). It has also been suggested that this apparently poor blood pressure control is caused, at least in part, by the so-called "white-coat effect," since casual blood pressure taken in medi...

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Effects of Bedtime vs. Morning Administration of the Long-Acting Lipophilic Angiotensin-Converting Enzyme Inhibitor Trandolapril on Morning Blood Pressure in Hypertensive Patients

Cited by 62 publications

References 44 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

Effectiveness of a Spot Urine Method in Evaluating Daily Salt Intake in Hypertensive Patients Taking Oral Antihypertensive Drugs

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

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