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J Pharmacol Sci. 2015 Jan;127(1):62-8. doi: 10.1016/j.jphs.2014.09.004. Epub 2014 Oct 2.

Different chronotherapeutic effects of valsartan and olmesartan in non-dipper hypertensive patients during valsartan treatment at morning.

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Department of Clinical Pharmacology, Jichi Medical University, Tochigi, Japan.
Matsunaga Cardiology Hospital, Oita, Japan.
Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
Kasaoka Dai-ichi Hospital, Okayama, Japan.
Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
Division of Nephrology, International University of Health and Welfare, Tochigi, Japan.
Department of Clinical Pharmacology, Jichi Medical University, Tochigi, Japan. Electronic address:


This study was undertaken to evaluate the differences in chronotherapeutic effects of angiotensin-II receptor blockers, valsartan and olmesartan in hypertensive patients with non-dipper blood pressure (BP) pattern during valsartan at morning. Ninety four patients were enrolled, and 40 patients were judged to be non-dippers. In these patients, same dose of valsartan was changed to evening (Val-E, n = 12), or olmesartan (equivalent dose of valsartan) was given at morning (Olm-M, n = 13) or evening (Olm-E, n = 15) for 4 months. BP decreased during sleep and increased during waking hours in Val-E group. In Olm-M and Olm-E groups, BP decreased during sleep and waking hours. Percent reduction in BP at night-time compared to BP at waking hours significantly increased after changing the dose regimen in each group. Serum creatinine decreased and estimated glomerular filtration rate (eGFR) elevated in Olm-M and Olm-E, but not Val-E groups. Positive correlation between systolic BP (SBP) during sleep and serum creatinine, and negative correlation between SBP during sleep and eGFR were detected. These data suggest that dipper BP pattern could be obtained by chronotherapeutic approach using valsartan and olmesartan in non-dipper patients with valsartan at morning. Morning and evening olmesartan, but not evening valsartan improved renal function in these patients.


ABPM; Angiotensin-II receptor blocker; Chronotherapy; Non-dipper; Renal function

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