Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

Chu, Chih‐Sheng; Lee, Kun-Tai; Chen, Shih-Hun; Lu, Ye-Hsu; Lin, Tsung-Hsien; Voon, Wen‐Chol; Sheu, Sheng‐Hsiung; Lai, Wen‐Ter

doi:10.1536/ihj.46.433

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…dipping status, resistant hypertension, etc.) [ 33 – 35 ]. Luo Y et al’s study demonstrated that 24 h BP profiles were normalized by taking amlodipine at the evening time [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical risk factors and predictive score for the non-dipper profile in hypertensive patients: a case-control study

2021

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Background Night-time BP, especially non-dipper, is a stronger predictor of adverse cardiovascular outcomes. Ambulatory blood pressure monitoring (ABPM) is a gold standard for the detection of non-dippers but it often is unavailable and expensive. This study aims to determine clinical risk factors that predict non-dipper. Methods An exploratory traditional case-control study, exclusive sampling of control was conducted from January 2013 to September 2018 to explore clinical risk factors associated with non-dippers in hypertensive patients. Subgroup analysis was performed in each treated and untreated hypertensive patient. The parsimonious predictive score for non-dippers was constructed. Results The study included 208 hypertensive patients receiving 24 h ABPM. There were 104 dippers and 104 non-dippers. Significant clinical risk factors associated with non-dippers were the age of > 65 years, average office diastolic blood pressure (DBP), and fasting plasma glucose of > 5.6 mmol/L. Results of subgroup analysis showed that dyslipidemia, history of coronary artery disease, use of angiotensin-converting enzyme inhibitors (ACEIs) and direct vasodilators, average office DBP, and serum uric acid were associated with non-dippers in treated hypertensive patients, however, there were no risk factors associated with non-dippers in the untreated group. The predictive score for non-dippers in treated group included average office DBP, dyslipidemia, serum uric acid, male, calcium channel blockers and ACEIs use. The area under Receiver Operating Characteristic (AuROC) was 0.723. A cut-off point which was > 0.0701 and prevalence of non-dippers of 46%, this score had a sensitivity of 77.4%, specificity of 65.6%, positive predictive value (PPV) of 66.1%, and negative predictive value (NPV) of 79.6%. For untreated group, age, hemoglobin and body mass index were included in the predictive model. AuROC was 0.74. There was a sensitivity of 51.9%, specificity of 91.2%, PPV of 82.4%, and NPV of 70.5% at the cut-off point of > 0.357, and prevalence of 44%. Conclusion There were several significant clinical risk factors associated with non-dippers in treated hypertensive patients. The predictive score might be useful for the detection of non-dippers; however, it cannot replace ABPM.

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“…dipping status, resistant hypertension, etc.) [ 33 – 35 ]. Luo Y et al’s study demonstrated that 24 h BP profiles were normalized by taking amlodipine at the evening time [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical risk factors and predictive score for the non-dipper profile in hypertensive patients: a case-control study

2021

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Efficacy of morning and evening dosing of amlodipine/valsartan combination in hypertensive patients uncontrolled by 5 mg of amlodipine

Asmar¹,

Gosse²,

Quéré³

et al. 2011

Blood Pressure Monitoring

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Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

Чибисов

Katinas

Brodskaya

et al. 2013

Cardiology Research and Practice

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Dynamics of blood pressure (BP) and heart rate (HR) was traced by automatic monitoring every 30 min uninterruptedly along several months in a patient suffering from combined atrial fibrillation and heart failure during the development of disease and its therapeutic and surgical treatment (pacemaker implanting and atrioventricular ablation). Analyses of spectral components as well as signal's shape revealed instabilities in circadian and semicircadian parameters. A new approach for signal's form description without using cosine approximation is suggested. The meaning that referring a patient as dipper, night peaker, or nondipper might be useful at choosing tactics of his treatment is impugned, because all these “types” can transform themselves in the same person in few days. Optimization timing of treatment provides better results if not the “types” of daily profile would be taken to account but the real form of the BP-signal and timing its first and second derivatives.

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Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

Cited by 3 publications

References 27 publications

Clinical risk factors and predictive score for the non-dipper profile in hypertensive patients: a case-control study

Clinical risk factors and predictive score for the non-dipper profile in hypertensive patients: a case-control study

Efficacy of morning and evening dosing of amlodipine/valsartan combination in hypertensive patients uncontrolled by 5 mg of amlodipine

Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

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