Comparison of effects of angiotensin II receptor blocker on morning home blood pressure and cardiorenal protection between morning administration and evening administration in hypertensive patients: the COMPATIBLE study

摘要

A recent study showed that bedtime administration of one or more antihypertensive medications results in better blood pressure (BP) control and greater cardiovascular risk reduction than morning administration. Although this was an important study based on hard end points, the results have yet to be confirmed. Alternatively, the benefits of antihypertensive therapy can be evaluated on the basis of intermediate surrogate end points, such as microalbuminuria and left ventricular hypertrophy. Several studies have shown that bedtime administration of antihypertensive agents is associated with a greater reduction in urinary albumin-to-creatinine ratio (UACR) than morning administration. However, it remains unclear whether reduced BP during sleep or the time of drug administration is more important. Several types of antihypertensive medications, including angiotensin receptor blockers (ARBs) antagonists, have been reported to be free of administration-time-dependent effects on the circadian pattern of BP. To confirm these results, we compared the effects of the ARB olmesartan on morning home BP (MHBP) and cardiovascular and renoprotective parameters between morning and evening administration.