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. 2013 Dec;5(6):432-40.
doi: 10.4021/jocmr1563w. Epub 2013 Oct 12.

Efficacies of Controlling Morning Blood Pressure and Protecting the Kidneys by Treatment With Valsartan and Nifedipine CR or Valsartan and Amlodipine (MONICA Study)

Tohru Tanaka  1 , Shin-Ichiro Miura, Masatoshi Tanaka, Yoshinari Uehara, Tadashi Hirano, Keijiro Saku
Affiliations

Efficacies of Controlling Morning Blood Pressure and Protecting the Kidneys by Treatment With Valsartan and Nifedipine CR or Valsartan and Amlodipine (MONICA Study)

Tohru Tanaka et al. J Clin Med Res. 2013 Dec.

Abstract

Background: It is controversial whether a single-pill fixed-dose combination of angiotensin II type 1 receptor blocker and calcium channel blocker (CCB) is effective for all types of hypertension.

Methods: Thirty-five patients with uncontrolled blood pressure (BP) under treatment with valsartan 80 mg/day or amlodipine 5 mg/day were enrolled. They were randomly divided into two treatment groups: a single-pill fixed-dose combination of valsartan 80 mg/day and amlodipine 5 mg/day in the morning (VA group), or valsartan 80 mg/day in the morning and nifedipine CR 20 mg/day at night (VN group), and treated for 16 weeks. If the patient did not reach the target office BP at 8 weeks, they received double doses of CCBs.

Results: In the VN group, morning diastolic BP was significantly lower than the respective values in the VA group at 8 weeks. The percentage of patients who required a double dose of CCB in the VN group was significantly lower than that in the VA group. At 16 weeks, the BP levels in both groups were significantly reduced. Urinary albumin/creatinine at 16 weeks was significantly less than that at 0 weeks in the VN group.

Conclusion: Combination therapy with valsartan and nifedipine CR may help to control morning BP and protect the kidneys.

Keywords: Albuminuria; Amlodipine; Combination therapy; Morning hypertension; Nifedipine CR.

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Figures

Figure 1
Figure 1
Changes in office SBP and DBP (a) and morning SBP and DBP (b) during the study period in the VA (gray lines) and VN (black lines) groups. *P < 0.05 vs. at 0 weeks. #P < 0.05 vs. VA group.
Figure 2
Figure 2
a). Reductions of office SBP and DBP from 0 weeks to 8 weeks in the VA and VN groups. b). Percentages of patients who required an increase in the dose of CCB at 8 weeks in the VA and VN groups. *P < 0.05 vs. VA group.
Figure 3
Figure 3
Markers of renal function, such as serum Cr (a), Cys-C (b) and U-Alb/U-Cr (c), during the study period in the VA (gray lines) and VN (black lines) groups. *P < 0.05 vs. at 0 weeks.
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References

    1. Dahlof B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, Collins R. et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet. 2005;366(9489):895–906. - PubMed
    1. Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Imai Y. et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009) Hypertens Res. 2009;32(1):3–107. - PubMed
    1. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G. et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) J Hypertens. 2007;25(6):1105–1187. - PubMed
    1. Miura S, Saku K. Efficacy and safety of angiotensin II type 1 receptor blocker/calcium channel blocker combination therapy for hypertension: focus on a single-pill fixed-dose combination of valsartan and amlodipine. J Int Med Res. 2012;40(1):1–9. - PubMed
    1. Kario K, White WB. Early morning hypertension: what does it contribute to overall cardiovascular risk assessment? J Am Soc Hypertens. 2008;2(6):397–402. - PubMed

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