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Hypertension
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my personal edition > hypertension > news
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DGDispatch
Bedtime Dosing of Atorvastatin and Valsartan Together Improves Overall Anti-Hypertensive Effects
By Ed Susman
SAN FRANCISCO, CA -- May 17, 2005 -- The addition of the cholesterol-lowering agent atorvastatin (Lipitor) improves the blood pressure lowering of valsartan (Diovan), providing a "win-win" situation for patients who are taking both anti-hypertensive and anti-cholesterol treatments.
"Atorvastatin significantly enhances the anti-hypertensive efficacy of valsartan," said Ramon Hermida, PhD, who presented data here May 15th at the 20th Annual Scientific Meeting and Exposition of the American Society of Hypertension. Dr. Hermida is director of the Bioengineering and Chronobiology Labs at the University of Vigo, Spain.
He explained that atorvastatin, when dosed with valsartan at bedtime, not only improved blood pressure lowering, but it more effectively controlled blood pressure in the early morning hours – when stroke, heart attacks, and other cardiovascular adverse events tend to occur most often.
"The synergistic combination markedly improves control of nocturnal blood pressure without loss in 24-hour efficacy, when both drugs are dosed at bedtime," said Dr. Hermida, pointing out that the added convenience of dosing both drugs at the same time might improve overall compliance.
The investigators studied 80 patients with Grade I and Grade 2 essential hypertension. Study subjects were divided the patients into four groups: valsartan (160 mg) alone, dosed at bedtime or in the daytime; valsartan (160 mg) plus atorvastatin (10 mg), dosed at bedtime or in the daytime.
Blood pressure was measured at 20-minute intervals from 7:00 a.m. until 11:00 p.m. and at 30-minute intervals at night for 48 consecutive hours before and after three months of therapy.
When valsartan was dosed by itself during the day, patients averaged a 9 mmHg fall in systolic blood pressure; daytime dosing of both valsartan and atorvastatin resulted in a 17 mmHg reduction in the 24-hour mean of systolic and diastolic BP. This difference was statistically significant at the P < .001 level. Taking valsartan alone at night produced a 10 mmHg fall in systolic blood pressure, but when the two drugs were taken together at bedtime, the reduction in systolic blood pressure reached 17 mmHg, also significant at the P < .001 level.
Similar favorable results were seen for diastolic blood pressure readings, for pulse pressure reductions, and for the diurnal/nocturnal blood pressure ratio, all of which favored the patient, Dr. Hermida said.
"The potential time-dependent efficacy of other blood pressure-lowering drugs administered in combination with statins should be investigated," he said.
[Presentation title: Administration Time-Dependent Efficacy of Valsartan-Atorvastatin Combination in Hyperlipidemic Patients With Essential Hypertension.]
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