Turk Kardiyol Dern Ars. 2016; 44(5): 404-413 | DOI: 10.5543/tkda.2015.98250
The effect of fixed-dose combination of valsartan and amlodipine on nighttime blood pressure in patients with non-dipper hypertension
, Atilla İçli, Fatih Aksoy, Salaheddin Akçay, Habil Yücel, İbrahim Ersoy, Mehmet Özaydın
Suleyman Demirel University, Faculty Of Medicine, Cardiology Department, Isparta, Turkey
OBJECTIVE Failure to decrease blood pressure (BP) during the night is associated with higher cardiovascular (CV) morbidity and mortality. There is strong evidence that fixed-dose combinations (FDCs) of antihypertensive agents are associated with significant improvement and non-significant adverse effects. The aim of the present study was to evaluate whether FDC affected nocturnal BP favorably in patients with uncontrolled, non-dipper hypertension (HT).
METHODS All non-dipper hypertensives were either newly diagnosed with stage 23 HT or had HT uncontrolled with monotherapy. Patients (n=195) were consecutively assigned to 4 treatment groups: FDC of valsartan/amlodipine (160/5 mg), free-drug combination of valsartan 160 mg and amlodipine 5 mg, amlodipine 10 mg, and valsartan 320 mg. Ambulatory blood pressure monitoring (ABPM) was repeated at 4th and 8th week.
RESULTS Average 24-h (24-hour) and nocturnal BP were similar among the groups at baseline evaluation, and had significantly decreased by the fourth week of treatment. However, BP continued to decrease only slightly between the 4th and 8th weeks in the valsartan and amlodipine monotherapy groups, but continued to decrease significantly in both combination groups. After 4 weeks, day-night BP difference and day-night BP % change were significantly elevated in the combination and valsartan groups. Between the 4th and 8th weeks, however, day-night BP difference and day-night BP % change continued to rise only in the FDC group, nearly reducing to baseline levels in the free-drug combination and valsartan groups. An additional 2.2 mmHg decrease was observed in the FDC group, compared to the free-drug combination group.
CONCLUSION In non-dipper HT, FDC of valsartan and amlodipine improved diurnal-nocturnal ratio of BP and provided 24-h coverage.
Amlodipine, ambulatory blood pressure, non-dipper, fixed dose combination; valsartan.
How to cite this article
Doğan Erdoğan, Atilla İçli, Fatih Aksoy, Salaheddin Akçay, Habil Yücel, İbrahim Ersoy, Mehmet Özaydın. The effect of fixed-dose combination of valsartan and amlodipine on nighttime blood pressure in patients with non-dipper hypertension. Turk Kardiyol Dern Ars. 2016; 44(5): 404-413
Corresponding Author: Doğan Erdoğan, Türkiye