Open AccessEnhanced Blood Pressure–Lowering Effect of Olmesartan in Hypertensive Patients With Chronic Kidney Disease–Associated Sympathetic Hyperactivity: HONEST Study
Author(s) -
Kario Kazuomi,
Saito Ikuo,
Kushiro Toshio,
Teramukai Satoshi,
Mori Yoshihiro,
Hiramatsu Katsutoshi,
Kobayashi Fumiaki,
Shimada Kazuyuki
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12132
Subject(s) - medicine , olmesartan , blood pressure , kidney disease , cardiology , morning , quartile , confidence interval
To investigate the blood pressure (BP)–lowering effect of olmesartan in relation to chronic kidney disease (CKD)–associated sympathetic nerve activity, a subanalysis was performed using data from the first 16 weeks of the Home BP Measurement With Olmesartan‐Naive Patients to Establish Standard Target Blood Pressure ( HONEST) study, a prospective observational study of hypertensive patients. Essential hypertensive patients who took no antihypertensive agent at baseline were classified based on baseline morning home systolic BP ( MHSBP ) in quartiles. In each class, patients were further classified based on baseline morning home pulse rate ( MHPR ). A subgroup analysis in patients with/without chronic kidney disease ( CKD ) was performed. A total of 5458 patients (mean age, 63.0 years; 51.6% women) were included. In the 4th quartile of baseline MHSBP (≥165 mm Hg), patients with MHPR ≥70 beats per minute had a greater BP reduction (by 3.2 mm Hg) than those with MHPR <70 beats per minute after 16 weeks of olmesartan‐based treatment ( P =.0005). An even greater BP reduction (by 6.6 mm Hg) was observed in patients with CKD than in patients without CKD in this group ( P =.0084). Olmesartan was more effective in hypertensive patients with high MHSBP and MHPR ≥70 beats per minute, especially in patients with CKD . Olmesartan may have enhanced BP ‐lowering effects by improving renal ischemia in hypertensive CKD patients with potential increased sympathetic nerve activity.