4) [2]. We investigated the suppressive effect of azelnidipine on clinic BP, morning home BP, and morning hypertension, using data collected in the At-HOME Study. The effect of azelnidipine on pulse rates was also examined. Fig. 4 Patient classification according to clinic systolic blood pressure (SBP) and morning home SBP in the Jichi Morning-buy S63845 hypertension Research

(J-MORE) Study [2] Clinic, morning home, and evening home SBP and DBP were significantly lowered by week 4 (p < 0.0001), and treatment had a significant BP-lowering effect (p < 0.0001) throughout the 16-week treatment period. Moreover, the changes in clinic BP, morning home BP, and evening home BP were significant (p < 0.0001). A greater proportion of patients

achieved clinic SBP of <140 mmHg (56.1 %) and morning home SBP of <135 mmHg (43.3 %) by week 16 in the present study than in the J-MORE Study (44 % for clinic SBP and 39 % for morning home PCI-34051 clinical trial SBP), and a greater proportion of patients achieved well-controlled hypertension (as assessed by both clinic SBP and morning SBP) in the present study than in the J-MORE Study (32.2 % vs. 21 %). The clinical effects of azelnidipine were assumed to be superior to those of conventional antihypertensive therapy (mainly calcium antagonists). In 41.0 % of patients with poorly controlled hypertension and 47.1 % of patients with masked hypertension at baseline, morning home BP was well controlled by azelnidipine treatment. Ohkubo et al. [12] and Kario et al. [13] reported that morning hypertension increased cerebrovascular and cardiovascular disease and stroke risks, and predicted asymptomatic cerebral infarction in the elderly [1]. GSK2118436 The Japan Morning Surge-1 (JMS-1) Study reported that strict control of morning hypertension could suppress hypertension-related organ damage [14]. When morning home BP is not measured in hypertensive patients, treatment of morning hypertension is likely to be inefficient, so measurement and strict control of morning home BP are extremely important. Azelnidipine is a slow-acting, sustained-effect dihydropyridine calcium antagonist and an antihypertensive drug that can be administered once daily

PRKD3 [15]. Because it has greater higher lipophilicity than other calcium antagonists, it has superior affinity for vascular tissues and prolonged distribution in them; strong binding to L-type calcium channels by the ‘membrane approach’; and slow, sustained, and strong hypotensive and anti-atherosclerotic activities [16, 17]. The results of this study suggest that azelnidipine has a sustained BP-lowering effect and usefulness in patients with morning hypertension at high risk of cardiovascular disease. Clinic, morning home, and evening home measurements showed a significant decrease in pulse rates (p < 0.0001) starting at week 4 and continuing up to week 16 (p < 0.0001), and the changes from baseline to the study endpoint were sustained (p < 0.0001).