Why the study?
Blood pressure normally decreases at night, but patterns vary among hypertensive individuals; this study aimed to evaluate blood pressure dipping patterns and variability using ambulatory blood pressure monitoring in patients treated with azilsartan.
In hypertensive patients receiving ongoing treatment with azilsartan, more than half exhibited a non-dipping nocturnal blood pressure pattern on 24-hour ambulatory monitoring.
Non-dipping nocturnal BP common on azilsartan; leaves open whether ABPM-guided therapy alters outcomes.
Aim: On average, blood pressure (BP) is found to be low during night than during day by approximately 10%–20%. In addition, BP decreases by >20% in some hypertensives or lowered by <10% or few patients may experience rise in BP during night compared to daytime BP. This study was performed to determine the dipping pattern of BP variability of the patients receiving azilsartan with the help of ambulatory BP monitoring (ABPM) system. Settings: This was a prospective, observational, open-label, single-center study. Materials and Methods: A total of 158 hypertensive patients (systolic BP [SBP] >140 mmHg; diastolic BP [DBP] >90 mmHg) were enrolled to performed ABPM and clinic BP monitoring with ongoing treatment with azilsartan. Statistical Analysis: Data are expressed as mean ± standard deviation. Statistical comparisons to test differences between two independent groups were by Student's t-test or Mann–Whitney's U-test as appropriate. Results: All patients monitored for 24-h BP measurement and reported to had SBP 133.76 ± 15.97 mmHg and DBP 76.16 ± 10.86 mmHg. Pulse rate was found to be 76.18 ± 11.82 bpm. BP variability was found to be high in 23.41% patients. Overall, study showed 34.17% dipper, 3.16% extreme dipper, 51.26% nondippers and 11.39% patients with reverse dipping pattern. In the present study, the dippers are classified to have 18.9% reduction in SBP, whereas 12.5% reduction in DBP. In the dippers group, only 4 patients had normal BP variation (2.53%), whereas high BP variation was found in 50 patients of the group (31.64%). Conclusions: ABPM had revealed higher SBP, BP variability (in almost one-fourth patients), dipping pattern and slightly higher pulse rates in hypertensive patients receiving azilsartan treatment. Around one-third of hypertensive patients were found to be dippers and more than half patients were non-dippers. Azilsartan has potent antihypertensive effect over 24 h and can be preferred in high-risk hypertensive patients.
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KAPARDHI et al. (2020) studied this question.
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