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Differences in 24-h blood pressure profile of Japanese hypertensive patients under ARB treatment
Toshihiro Kita1, Atsushi Sakima2,3, Naoto Yokota4
1a Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine , University of Miyazaki , Miyazaki , Japan .
Insights
Different angiotensin-II receptor blockers (ARBs) show distinct 24-hour blood pressure profiles. Olmesartan significantly lowered nighttime blood pressure compared to other ARBs, highlighting variability in ARB effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Optimal cardiovascular protection requires consistent 24-hour blood pressure (BP) control.
- Angiotensin-II receptor blockers (ARBs) are a common treatment for hypertension due to their class benefits.
Purpose of the Study:
- To investigate potential differences in 24-hour BP profiles among various ARBs.
- To compare the efficacy of different ARBs in managing ambulatory BP.
Main Methods:
- Ambulatory blood pressure monitoring (ABPM) was conducted on 211 Japanese hypertensive patients.
- Patients were categorized into five groups based on the prescribed ARB.
- Demographic and clinical data were collected and analyzed.
Main Results:
- No significant differences were observed in office, 24-hour, or daytime BP across the five ARB groups.
- Nighttime BP was significantly lower in patients treated with olmesartan compared to other ARBs.
- Office BP correlated well with 24-hour BP for candesartan and telmisartan.
- Higher correlations between daytime and nighttime BP were noted with candesartan and telmisartan.
- Office pulse pressure correlated with ambulatory arterial stiffness index and systolic BP fluctuation.
Conclusions:
- Different ARBs can lead to meaningful variations in 24-hour BP profiles.
- Olmesartan demonstrated a distinct effect on nighttime BP reduction.
- Candesartan and telmisartan showed better correlation between office and ambulatory BP measurements.
Abstract:
Blood pressure (BP) control throughout the entire day is recommended for cardiovascular protection. Angiotensin-II receptor blockers (ARBs) are widely used in hypertensive patients because of beneficial class effects. It is uncertain, however, whether are there any differences in 24-h BP profiles among ARBs. We examined ambulatory blood pressure monitoring (ABPM) among 211 Japanese hypertensive patients (age, 69.4 ± 9.6 years; female, 59.2%) under treatment with five different ARBs. Patients were divided into five groups according to ARBs prescribed. Patient backgrounds were almost identical in all the groups and there were no differences in office, 24-h and daytime BP; however, nighttime BP with olmesartan was significantly lower than with other ARBs. Office BPs with candesartan and telmisartan, but not other ARBs, correlated well with 24-h BP (p < 0.01). Also, there were higher correlations between daytime and nighttime BP with candesartan and telmisartan. In all patients, pulse pressure with office BP was significantly correlated with ambulatory arterial stiffness index (p = 0.001) and fluctuation of systolic BP on ABPM (p = 0.002). In conclusion, different ARB treatments produced meaningful differences in 24-h profiles.
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