No significant differences were observed in any parameters (the characteristics of patients and BP profiles at the initiation of the study shown in Table 1 and Table 2) among the valsartan-E, olmesartan-M and olmesartan-E groups. BP profiles at the end of the study are also shown in Table 2. Comparing BP values between before and after changing the dose regimen in each group, the changes in mean value of BP at the end of the study were −4.1 mmHg (SBP) and −2.2 mmHg (DBP) during sleep, and +7.9 mmHg (SBP) and +4.2 mmHg (DBP) during waking hours in the valsartan-E group (Fig. 2a). In the olmesartan-M

and olmesartan-E groups, Bortezomib the mean value of BP decreased significantly during sleep (SBP, −11.1 mmHg, DBP, −7.4 mmHg, p < 0.01 and SBP, −8.3 mmHg, p < 0.05, respectively) ( Fig. 2b, c). The changes in mean value of BP during waking hours were −3.7 mmHg (SBP) and −3.1 mmHg (DBP) in the olmesartan-M group, and were −1.4 mmHg (SBP) and +0.4 mmHg (DBP) in the olmesartan-E group. The percent reduction in SBP during night-time compared to SBP during waking hours significantly increased

at 4 months after changing the dose regimen in each group as follows; 2.4 ± 6.3 to 10.5 ± 3.8% in the valsartan-E (p < 0.01), 4.3 ± 4.0 to 10.1 ± 6.4% in the olmesartan-M (p < 0.05) and 1.2 ± 5.0 to 6.4 ± 10.4% in the olmesartan-E (p < 0.05) groups check details ( Fig. 3). Isotretinoin The number of patients with a dipper BP pattern was 7/11 (64%) in the valsartan-E, 5/11 (46%) in the olmesartan-M and 5/12 (42%) in the olmesartan-E groups. Serum creatinine slightly, but significantly decreased (p < 0.05) in the olmesartan-treated groups, and eGFR significantly elevated (p < 0.05)

in the olmesartan-M group and tended to elevate (p = 0.06) in the olmesartan-E group after dosing the drug for 4 months ( Table 3). Renal function was not significantly improved in the valsartan-E group. Positive correlations were detected between SBP during sleep and serum creatinine in all (p < 0.05) and non-dipper (p = 0.06) patients ( Fig. 4a). In addition, there were negative correlations between SBP during sleep and eGFR in all (p < 0.05) and non-dipper (p < 0.05) patients ( Fig. 4b). No significant correlations were observed between other BP measurements (SBP during waking hours, DBP during sleep and waking hours, 24-h SBP and DBP) and serum creatinine (or eGFR). In this study, the percentage of patients with a non-dipper BP pattern given a morning dose of valsartan for >2 months was 43.5%, which is similar to those reported in other studies (45.7–57.8%) (11) and (12). The effect of antihypertensive drugs can be influenced by a dosing-time, and appropriate timing of dosing is likely to correct an abnormal BP pattern (17).