Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Jan;15(1):48-54.
doi: 10.1111/jch.12021. Epub 2012 Oct 9.

Effect of valsartan with bedtime dosing on chronic kidney disease patients with nondipping blood pressure pattern

Cheng Wang  1 , Jun Zhang, Xun Liu, Cui-Cui Li, Zeng Chun Ye, Hui Peng, Zhujiang Chen, Tanqi Lou
Affiliations
Randomized Controlled Trial

Effect of valsartan with bedtime dosing on chronic kidney disease patients with nondipping blood pressure pattern

Cheng Wang et al. J Clin Hypertens (Greenwich). 2013 Jan.

Abstract

Nondipping blood pressure (BP) pattern is a potential independent risk factor for chronic kidney disease (CKD). Bedtime administration of valsartan is considered to normalize circadian rhythm and protect the kidneys and heart in CKD patients. However, more clinical trials are needed to confirm this benefit. Sixty patients with nondipping BP pattern and thirty patients with dipping BP pattern were enrolled in this study, and the patients with nondipping BP pattern were randomly divided into two groups and treated with bedtime or awakening doses of valsartan (80-320 mg). Nondipping BP patients treated with bedtime doses of valsartan showed a greater reduction in 24-hour proteinuria and bedtime proteinuria, a greater delayed decline in estimated glomerular filtration rate, and more protection against myocardial hypertrophy (P<.05) compared with patients with the nondipping BP pattern treated with the awakening dose (P<.05). This was similar to patients with dipping BP. No severe clinical complications were recorded in these patients. Valsartan with bedtime dosing in CKD patients with the nondipping BP pattern have better renal and cardiovascular protection. Antihypertensive "chronotherapy" may be useful in clinical practice for CKD patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Comparison of blood pressure after valsartan therapy in the three groups. (A) Changes in systolic blood pressure after valsartan therapy in the three groups. (B) Changes in diastolic blood pressure after valsartan therapy in the three groups. (C) Comparison of the ratio of bedtime/awakening systolic blood pressure after valsartan therapy in the three groups. (D) Comparison of the ratio of bedtime/awakening diastolic blood pressure after valsartan therapy in the three groups.
Figure 2
Figure 2
Comparison of the changes in glomerular filtration rate and proteinuria after valsartan therapy in the three groups. (A) Changes in glomerular filtration rate after valsartan therapy in the three groups. (B) Changes in proteinuria after valsartan therapy in the three groups.
Figure 3
Figure 3
Comparison of ultrasonography parameters after valsartan therapy in the three groups. (A) Changes in left ventricular mass index after valsartan therapy in the three groups. (B) Changes in left ventricular ejection fraction after valsartan therapy in the three groups. (C) Changes in E/A ratio after valsartan therapy in the three groups. (D) Changes in carotid intima‐media thickness after valsartan therapy in the three groups.
See this image and copyright information in PMC

References

    1. Davidson MB, Hix JK, Vidt DG, Brotman DJ. Association of impaired diurnal blood pressure variation with a subsequent declinein glomerular filtration rate. Arch Intern Med. 2006;166:846–852. - PubMed
    1. Liu M, Takahashi H, Morita M, et al. Non‐dipping is a potent predictor of cardiovascular mortality and is associated with autonomic dysfunction in haemodialysis patients. Nephrol Dial Transplant. 2003;18:563–569. - PubMed
    1. Torbjornsdotter TB, Jaremkl GA, Berg UB. Nondipping and its relation to glomerulopathy and hyperfiltration in adolescents with type 1 diabetes. Diabetes Care. 2004;27:510–516. - PubMed
    1. Tamura K, Kanaoka T, Ohsawa M, et al. Emerging concept of anti‐hypertensive therapy based on ambulatory blood pressure profile in chronic kidney disease. Am J Cardiovasc Dis. 2011;1:236–243. - PMC - PubMed
    1. Hermida RC, Ayala DE, Fontao MJ, Mojón A, Fernández JR. Chronotherapy with valsartan/amlodipine fixed combination: improved blood ressure control of essention hypertension with bedtime dosing. Chronobiol Int. 2010;27:1287–1303. - PubMed

Publication types