Effect of Valsartan With Bedtime Dosing on Chronic Kidney Disease Patients With Nondipping Blood Pressure Pattern
Article first published online: 9 OCT 2012
© 2012 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 1, pages 48–54, January 2013
How to Cite
Wang, C., Zhang, J., Liu, X., Li, C.-C., Ye, Z. C., Peng, H., Chen, Z. and Lou, T. (2013), Effect of Valsartan With Bedtime Dosing on Chronic Kidney Disease Patients With Nondipping Blood Pressure Pattern. The Journal of Clinical Hypertension, 15: 48–54. doi: 10.1111/jch.12021
- Issue published online: 3 JAN 2013
- Article first published online: 9 OCT 2012
- Manuscript received: June 22, 2012; revised: August 16, 2012; accepted: August 22, 2012
Nondipping blood pressure (BP) pattern is a potential independent risk factor for chronic kidney disease (CKD). Bedtime administration of valsartan is considered to normalize circadian rhythm and protect the kidneys and heart in CKD patients. However, more clinical trials are needed to confirm this benefit. Sixty patients with nondipping BP pattern and thirty patients with dipping BP pattern were enrolled in this study, and the patients with nondipping BP pattern were randomly divided into two groups and treated with bedtime or awakening doses of valsartan (80–320 mg). Nondipping BP patients treated with bedtime doses of valsartan showed a greater reduction in 24-hour proteinuria and bedtime proteinuria, a greater delayed decline in estimated glomerular filtration rate, and more protection against myocardial hypertrophy (P<.05) compared with patients with the nondipping BP pattern treated with the awakening dose (P<.05). This was similar to patients with dipping BP. No severe clinical complications were recorded in these patients. Valsartan with bedtime dosing in CKD patients with the nondipping BP pattern have better renal and cardiovascular protection. Antihypertensive “chronotherapy” may be useful in clinical practice for CKD patients.