| Decrease in urinary albumin excretion associated with the normalization of nocturnal blood pressure in hypertensive subjects. | |
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MedLine Citation:
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PMID: 16144987 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Previous results have indicated that valsartan administration at bedtime as opposed to on wakening improves the diurnal/nocturnal ratio of blood pressure without loss in efficacy and therapeutic coverage. We hypothesized that increasing this ratio could reduce microalbuminuria. We conducted a prospective, randomized, open-label, blinded endpoint trial on 200 previously untreated nonproteinuric patients with grade 1 to 2 essential hypertension, assigned to receive valsartan (160 mg/d) as a monotherapy either on awakening or at bedtime. Blood pressure was measured by ambulatory monitoring for 48 consecutive hours before and after 3 months of treatment. Physical activity was simultaneously monitored every minute by wrist actigraphy to accurately calculate the diurnal and nocturnal means of blood pressure on a per-subject basis. The significant blood pressure reduction after 3 months of therapy was similar for both treatment times. The diurnal/nocturnal blood pressure ratio was unchanged after valsartan on awakening, but significantly increased from 7.5 to 12.2 (P<0.001) when valsartan was administered at bedtime. Urinary albumin excretion was significantly reduced by 41% after bedtime treatment. This reduction was independent of the 24-hour blood pressure decrease but highly correlated with the decrease in nocturnal blood pressure and mainly with the increase in diurnal/nocturnal ratio (P<0.001). Bedtime valsartan administration improves the diurnal/nocturnal blood pressure ratio to a more dipper profile. This normalization of the circadian blood pressure pattern is associated with a significant decrease in urinary albumin excretion and plasma fibrinogen, and could thus reduce the increased cardiovascular risk in nondipper hypertensive patients. |
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Authors:
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Ramón C Hermida; Carlos Calvo; Diana E Ayala; José E López |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2005-09-06 |
Journal Detail:
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Title: Hypertension Volume: 46 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-30 Completed Date: 2005-12-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 960-8 Citation Subset: IM |
Affiliation:
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Bioengineering Laboratory, University of Vigo, Campus Universitario, Vigo, Spain. rhermida@tsc.uvigo.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Albuminuria / physiopathology* Angiotensin II Type 1 Receptor Blockers / administration & dosage*, therapeutic use Blood Pressure / drug effects* Blood Pressure Monitoring, Ambulatory Circadian Rhythm* Double-Blind Method Drug Administration Schedule Female Fibrinogen / metabolism Humans Hypertension / drug therapy*, physiopathology*, urine Male Middle Aged Prospective Studies Tetrazoles / administration & dosage*, therapeutic use Valine / administration & dosage, analogs & derivatives*, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin II Type 1 Receptor Blockers; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine; 9001-32-5/Fibrinogen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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