Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives: The Japan Morning Surge-Target Organ Protection (J-TOP) study

Kazuomi Kario, Satoshi Hoshide, motohiro shimizu, Yuichiro Yano, Kazuo Eguchi, Joji Ishikawa, Shizukiyo Ishikawa, Kazuyuki Shimada

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Objectives: To study the impact of the dosing time of an angiotensin II receptor blocker (ARB) titrated by self-measured home blood pressure (HBP) on cardiorenal damage in hypertensives. Methods: We conducted an open-label multicenter trial, the J-TOP study, that enrolled 450 hypertensives with self-measured systolic HBP more than 135 mmHg. The study patients were stratified into three groups according to the difference between their morning and evening SBPs difference: a morning hypertension group (morning and evening difference at least 15 mmHg; n = 170), a morning and evening hypertension group (0 mmHg ≤ morning and evening difference <15 mmHg; n = 198), and an evening hypertension group (morning and evening difference <0 mmHg; n = 82). Individuals were then randomly allocated to receive bedtime dosing or awakening dosing of candesartan (± diuretic as needed) titrated to achieve a target systolic HBP less than 135 mmHg. The 6-month change in the urinary albumin/creatinine ratio (UACR) was assessed. Results: In total patients, the UACR was more markedly reduced in the bedtime-dosing group than in the awakening-dosing group (-45.7 vs.-34.5%, P = 0.02), whereas there were no differences in the reduction of any of the HBPs including the sleep blood pressures (BPs) between the two groups. Among the three subgroups stratified by the morning and evening difference, the difference in the UACR reduction between the bedtime-dosing and awakening-dosing groups was only significant in the morning hypertension group (-50.6 vs.-31.3%, P = 0.02). Conclusion: In HBP-guided antihypertensive treatment in hypertensives, bedtime dosing of an ARB may be superior to awakening dosing for reducing microalbuminuria.

Original languageEnglish
Pages (from-to)1574-1583
Number of pages10
JournalJournal of hypertension
Volume28
Issue number7
DOIs
Publication statusPublished - Jul 1 2010

Fingerprint

Angiotensin Receptors
Japan
Blood Pressure
Hypertension
Albumins
Creatinine
Angiotensin Receptor Antagonists
Diuretics
Antihypertensive Agents
Multicenter Studies
Sleep

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives : The Japan Morning Surge-Target Organ Protection (J-TOP) study. / Kario, Kazuomi; Hoshide, Satoshi; shimizu, motohiro; Yano, Yuichiro; Eguchi, Kazuo; Ishikawa, Joji; Ishikawa, Shizukiyo; Shimada, Kazuyuki.

In: Journal of hypertension, Vol. 28, No. 7, 01.07.2010, p. 1574-1583.

Research output: Contribution to journalArticle

Kario, Kazuomi ; Hoshide, Satoshi ; shimizu, motohiro ; Yano, Yuichiro ; Eguchi, Kazuo ; Ishikawa, Joji ; Ishikawa, Shizukiyo ; Shimada, Kazuyuki. / Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives : The Japan Morning Surge-Target Organ Protection (J-TOP) study. In: Journal of hypertension. 2010 ; Vol. 28, No. 7. pp. 1574-1583.
@article{0158aa54dddb438d800392ef9b4b8d40,
title = "Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives: The Japan Morning Surge-Target Organ Protection (J-TOP) study",
abstract = "Objectives: To study the impact of the dosing time of an angiotensin II receptor blocker (ARB) titrated by self-measured home blood pressure (HBP) on cardiorenal damage in hypertensives. Methods: We conducted an open-label multicenter trial, the J-TOP study, that enrolled 450 hypertensives with self-measured systolic HBP more than 135 mmHg. The study patients were stratified into three groups according to the difference between their morning and evening SBPs difference: a morning hypertension group (morning and evening difference at least 15 mmHg; n = 170), a morning and evening hypertension group (0 mmHg ≤ morning and evening difference <15 mmHg; n = 198), and an evening hypertension group (morning and evening difference <0 mmHg; n = 82). Individuals were then randomly allocated to receive bedtime dosing or awakening dosing of candesartan (± diuretic as needed) titrated to achieve a target systolic HBP less than 135 mmHg. The 6-month change in the urinary albumin/creatinine ratio (UACR) was assessed. Results: In total patients, the UACR was more markedly reduced in the bedtime-dosing group than in the awakening-dosing group (-45.7 vs.-34.5{\%}, P = 0.02), whereas there were no differences in the reduction of any of the HBPs including the sleep blood pressures (BPs) between the two groups. Among the three subgroups stratified by the morning and evening difference, the difference in the UACR reduction between the bedtime-dosing and awakening-dosing groups was only significant in the morning hypertension group (-50.6 vs.-31.3{\%}, P = 0.02). Conclusion: In HBP-guided antihypertensive treatment in hypertensives, bedtime dosing of an ARB may be superior to awakening dosing for reducing microalbuminuria.",
author = "Kazuomi Kario and Satoshi Hoshide and motohiro shimizu and Yuichiro Yano and Kazuo Eguchi and Joji Ishikawa and Shizukiyo Ishikawa and Kazuyuki Shimada",
year = "2010",
month = "7",
day = "1",
doi = "10.1097/HJH.0b013e3283395267",
language = "English",
volume = "28",
pages = "1574--1583",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives

T2 - The Japan Morning Surge-Target Organ Protection (J-TOP) study

AU - Kario, Kazuomi

AU - Hoshide, Satoshi

AU - shimizu, motohiro

AU - Yano, Yuichiro

AU - Eguchi, Kazuo

AU - Ishikawa, Joji

AU - Ishikawa, Shizukiyo

AU - Shimada, Kazuyuki

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Objectives: To study the impact of the dosing time of an angiotensin II receptor blocker (ARB) titrated by self-measured home blood pressure (HBP) on cardiorenal damage in hypertensives. Methods: We conducted an open-label multicenter trial, the J-TOP study, that enrolled 450 hypertensives with self-measured systolic HBP more than 135 mmHg. The study patients were stratified into three groups according to the difference between their morning and evening SBPs difference: a morning hypertension group (morning and evening difference at least 15 mmHg; n = 170), a morning and evening hypertension group (0 mmHg ≤ morning and evening difference <15 mmHg; n = 198), and an evening hypertension group (morning and evening difference <0 mmHg; n = 82). Individuals were then randomly allocated to receive bedtime dosing or awakening dosing of candesartan (± diuretic as needed) titrated to achieve a target systolic HBP less than 135 mmHg. The 6-month change in the urinary albumin/creatinine ratio (UACR) was assessed. Results: In total patients, the UACR was more markedly reduced in the bedtime-dosing group than in the awakening-dosing group (-45.7 vs.-34.5%, P = 0.02), whereas there were no differences in the reduction of any of the HBPs including the sleep blood pressures (BPs) between the two groups. Among the three subgroups stratified by the morning and evening difference, the difference in the UACR reduction between the bedtime-dosing and awakening-dosing groups was only significant in the morning hypertension group (-50.6 vs.-31.3%, P = 0.02). Conclusion: In HBP-guided antihypertensive treatment in hypertensives, bedtime dosing of an ARB may be superior to awakening dosing for reducing microalbuminuria.

AB - Objectives: To study the impact of the dosing time of an angiotensin II receptor blocker (ARB) titrated by self-measured home blood pressure (HBP) on cardiorenal damage in hypertensives. Methods: We conducted an open-label multicenter trial, the J-TOP study, that enrolled 450 hypertensives with self-measured systolic HBP more than 135 mmHg. The study patients were stratified into three groups according to the difference between their morning and evening SBPs difference: a morning hypertension group (morning and evening difference at least 15 mmHg; n = 170), a morning and evening hypertension group (0 mmHg ≤ morning and evening difference <15 mmHg; n = 198), and an evening hypertension group (morning and evening difference <0 mmHg; n = 82). Individuals were then randomly allocated to receive bedtime dosing or awakening dosing of candesartan (± diuretic as needed) titrated to achieve a target systolic HBP less than 135 mmHg. The 6-month change in the urinary albumin/creatinine ratio (UACR) was assessed. Results: In total patients, the UACR was more markedly reduced in the bedtime-dosing group than in the awakening-dosing group (-45.7 vs.-34.5%, P = 0.02), whereas there were no differences in the reduction of any of the HBPs including the sleep blood pressures (BPs) between the two groups. Among the three subgroups stratified by the morning and evening difference, the difference in the UACR reduction between the bedtime-dosing and awakening-dosing groups was only significant in the morning hypertension group (-50.6 vs.-31.3%, P = 0.02). Conclusion: In HBP-guided antihypertensive treatment in hypertensives, bedtime dosing of an ARB may be superior to awakening dosing for reducing microalbuminuria.

UR - http://www.scopus.com/inward/record.url?scp=77954386510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954386510&partnerID=8YFLogxK

U2 - 10.1097/HJH.0b013e3283395267

DO - 10.1097/HJH.0b013e3283395267

M3 - Article

C2 - 20404743

AN - SCOPUS:77954386510

VL - 28

SP - 1574

EP - 1583

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 7

ER -