CHICAGO — Bedtime dosing of valsartan is more efficient than morning dosing in controlling blood pressure and improving renal function in hypertensive patients with or without diabetes, Ramon Hermida, Ph.D., said at the annual meeting of the American Society of Hypertension.
He suggested this effect may be class related for angiotensin II receptor blockers (ARBs) and should be taken into account when treating patients with hypertension.
Dr. Hermida and his colleagues randomized 204 untreated hypertensive patients to receive valsartan 160 mg/day either upon awakening or at bedtime. Blood pressure was measured at 20-minute intervals from 7:00 a.m. to 11:00 p.m., and at 30-minute intervals at night for 48 hours before and after 12 weeks of therapy. Patients collected urine samples during the first 24 hours of monitoring. Their mean age was 52 years; 97 had type 2 diabetes mellitus.
Bedtime dosing with valsartan was significantly more efficient than morning dosing in reducing nocturnal BP in those with or without diabetes, said Dr. Hermida, of the University of Vigo (Spain). The diurnal/nocturnal BP ratio was unchanged after taking valsartan on awakening, but significantly increased by 5.3% when taken before bedtime. Urinary albumin excretion was significantly reduced by 23% from baseline in patients without diabetes and by 31% in those with diabetes only after bedtime administration, said Dr. Hermidat.