Reduction in Morning Blood Pressure Is a Key Factor for Ameliorating Urinary Albumin Excretion in Patients With Morning Hypertension Irrespective of Treatment Regimen
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概要
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Background: The Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy (MAPPY) study has shown that losartan/hydrochlorothiazide (HCTZ) combination is superior to high-dose losartan in not only reducing morning systolic blood pressure (SBP) but also ameliorating urinary albumin excretion (UAE) after 3-month treatment. The purpose of the present study was to investigate factors associated with UAE reduction in on-treatment patients with morning hypertension. Methods and Results: A total of 95 patients registered in the MAPPY study were analyzed. Patients were treated with either a losartan/HCTZ combination regimen (n=47) or a high-dose losartan regimen (n=48). Three-month treatment significantly reduced morning SBP, evening SBP, and clinic SBP (P<0.001, P<0.05, and P<0.01, respectively). UAE and serum uric acid were significantly decreased (P<0.01 for both) without the change in estimated glomerular filtration rate. Multiple linear regression analysis indicated that %morning SBP reduction and baseline UAE were independent determinants of the UAE reduction (P=0.001 for both). After adjustments for the reduction in morning-evening SBP difference, baseline UAE, and %uric acid reduction, estimated %UAE reduction level was positively correlated with the tertiles of the increasing %morning SBP reduction level (P=0.031 for trend). Moreover, subgroup analysis showed that morning SBP reduction was an independent determinant of UAE reduction in both treatment regimens. Conclusions: Reduction in morning SBP was a key factor in UAE reduction in patients with morning hypertension, irrespective of treatment regimen.
- 社団法人 日本循環器学会の論文
著者
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Adachi Hisashi
Department of Cardio-Vascular Medicine, Kurume University School of Medicine
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Toyama Yasuyuki
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University
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Kusaba Ken
Department Of Internal Medicine Division Of Cardio-vascular Medicine Kurume University School Of Med
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Kai Hisashi
Department Of Internal Medicine Division Of Cardio-vascular Medicine And Cardiovascular Research Ins
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Shihara Miwako
Department Of Cardiovascular Medicine Cardiovascular Science Graduate School Of Medical Sciences Kyu
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Imaizumi Tsutomu
Deparment Of Medicine Division Of Cardiovascular Medicine Kurume University School Of Medicine
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Umei Hidekazu
Department Of Internal Medicine Iii Kurume University School Of Medicine
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Ueda Tamenobu
Department Of Internal Medicine Division Of Cardio-vascular Medicine Kurume University School Of Medicine
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Kusaba Ken
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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Mitsutake Yoshiaki
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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Kaneyuki Masashi
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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Umei Hidekazu
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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Toyama Yasuyuki
Department of Internal Medicine Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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