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Comparative Efficacy of Aliskiren/Valsartan vs Valsartan in Nocturnal Dipper and Nondipper Hypertensive Patients: A Pooled Analysis.
MedLine Citation:
PMID:  22533656     Owner:  NLM     Status:  In-Data-Review    
J Clin Hypertens (Greenwich). 2012; 14:299-306. ©2012 Wiley Periodicals, Inc. This pooled analysis of ambulatory blood pressure (BP) monitoring data from two 8-week randomized controlled trials compared the antihypertensive efficacy and safety of combination aliskiren/valsartan vs valsartan alone in hypertensive patients (nocturnal dippers or nondippers). At study end, patients were taking aliskiren/valsartan 300/320 mg or valsartan 320 mg. In dippers (n=138) and nondippers (n=132), aliskiren/valsartan provided significantly (P<.05) greater reductions from baseline to week 8 than valsartan in 24-hour, daytime, and last-4-hour mean ambulatory systolic BP (maSBP). Treatment differences were more pronounced in nondippers. Nighttime maSBP reductions with aliskiren/valsartan were significantly greater vs valsartan in nondippers (-17.0 mm Hg vs -8.9 mm Hg; P<.05) but not dippers (-7.6 mm Hg vs -4.5 mm Hg; P=.16). In all time periods, combination therapy was generally associated with BP reductions that were greater in nondippers than dippers. Conversion from nondipper to dipper status was 32% vs 22% for aliskiren/valsartan vs valsartan (P=.48). Both treatments were similarly well tolerated. Although the addition of aliskiren to valsartan did not significantly alter dipper status, our data suggest an increased contribution of the renin-angiotensin-aldosterone system to the nondipper status of hypertensive patients.
Thomas D Giles; Thomas Alessi; Das Purkayastha; Dion Zappe
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Publication Detail:
Type:  Journal Article     Date:  2012-03-16
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  14     ISSN:  1751-7176     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-306     Citation Subset:  IM    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
From the Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA;1 and the Novartis Pharmaceuticals Corporation, East Hanover, NJ 2.
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