The stroke risk check details increased by 41 % with a 10 mmHg increase in ME average and by 24 % with a 10 mmHg increase in ME difference. Given that other cardiovascular risks also increase in the morning, the diagnosis of morning hypertension and control of BP have tremendous significance. In the practical treatment of morning hypertension, it is ideal to combine the nonspecific approach of lowering ME average of home BP and the specific approach of reducing greater than threshold ME differences, leading the vector of BP lowering to
normal BP limits [5]. Azelnidipine is a dihydropyridine calcium antagonist, which was synthesized by Ube Industries, Ltd. and developed by Sankyo Co., Ltd. (now known as Daiichi Sankyo Co., Ltd., Tokyo, Japan). This agent has a potent and sustained BP-lowering effect in various animal models of hypertension [9]. It has also been confirmed to have renoprotective effects (such as reducing proteinuria by dilating efferent arterioles), as well as cardioprotective,
insulin resistance-improving, cerebroprotective, and anti-atherosclerotic Selleckchem Protease Inhibitor Library effects [10, 11]. In this study using the results from our previously reported special survey of azelnidipine (the Azelnidipine Treatment for Hypertension Open-label Monitoring in the Early morning [At-HOME] Study [12]), we performed subgroup analyses in cases with measurements of BP at home in the evening (evening home BP), to evaluate the effects of the agent on morning and evening home BP, using mainly ME average and ME difference as measures. 2 Subjects and Methods 2.1 Subjects The At-HOME study [12] Angiogenesis inhibitor was conducted according to Article 14-4 (re-examination) of the Pharmaceutical Affairs Act, Japan, and in compliance with Good Post-marketing Study Practice (GPSP). For a list of participating
medical centers [in Japanese], see the electronic supplementary material. The study included patients who met all of the following requirements at baseline when they started taking the study drug, azelnidipine (Calblock® tablets; Daiichi Sankyo Co., Ltd.): (i) outpatient with hypertension; (ii) no previous use of the study drug; (iii) clinic BP measurement within 28 days prior to baseline; and (iv) morning home BP measurement using an electronic brachial-cuff device at least two times on separate dates within 28 days prior to baseline. The study was conducted using the central enrollment method, in which patients from contracted medical institutions nationwide were registered by the enrollment center within 14 days after the baseline date. The enrollment period was one year from May 2006, and the planned number of cases to be investigated was 5,000. From among the patients who were included in the primary analysis of the At-HOME Study [12], cases with evening home BP measurements within 28 days prior to the baseline date are described in this article.
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