Bedtime Administration of Cilnidipine Controls Morning Hypertension
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概要
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Morning blood pressure (BP) level plays an important role in the incidence of cardiovascular disease. Recently, Kario, et al proposed the usefulness of ME difference (morning minus evening systolic BP) and ME average (average of morning and evening systolic BP) for the evaluation of antihypertensive treatment. Cilnidipine is a novel calcium channel blocker (CCB) that exerts inhibitory actions not only on L-type but also on N-type calcium channels. We investigated the effect of bedtime administration of cilnidipine (10 mg) in addition to the antihypertensive treatment for uncontrolled morning hypertension. Twenty-three hypertensive outpatients (13 males and 10 females; mean age, 66.9 years) with stable antihypertensive medication and uncontrolled morning BP were studied using self-measured BP monitoring in the morning and evening. Morning SBP (P < 0.001) and DBP (P < 0.001) decreased significantly from 150.2 ± 8.7 and 87.8 ± 9.3 to 132.7 ± 7.4 and 77.5 ± 8.5 mmHg, respectively, after the addition of cilnidipine. Morning heart rate did not change (63.3 ± 7.0 to 64.1 ± 9.4). The evening SBP, but not DBP, decreased significantly after treatment. Both the ME average (P < 0.001) and ME difference (P < 0.01) significantly decreased from 143.0 ± 9.2 and 14.3 ± 12.4 to 131.3 ± 7.2 and 2.8 ± 9.2 mmHg after treatment, respectively. The microalbuminuria decreased from 39.6 ± 13.2 to 27.3 ± 8.4 mg/g Cr. In conclusion, L-/N-type CCB cilnidipine may be useful for patients with uncontrollable morning hypertension by reducing both ME average and ME difference.
著者
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Ashizawa Naoto
Division Of Cardiovascular Medicine Department Of Translational Medical Sciences Course Of Medical A
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Yano Katsusuke
Division Of Cardiovascular Medicine Department Of Translational Medical Sciences Course Of Medical A
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Ashizawa Naoto
Division of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
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Shibata Yoshisada
Division of Radiation Epidemiology, Course of Life Sciences and Radiation Research, Graduate School of Biomedical Sciences, Nagasaki University
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Seto Shinji
Division of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
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Yano Katsusuke
Division of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
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