Efficacy of manidipine on circadian blood pressure in essential hypertension.

The 24-h blood pressure (BP) response to once-daily manidipine monotherapy was examined in an open, nonrandomized study of 17 patients with untreated essential hypertension. Manidipine (10-30 mg) was administered once daily for a minimum of 2 weeks. BP and heart rate (HR) were monitored every 30 min for 48 h by an ambulatory BP monitoring device (ABPM-630, Nippon Colin) before and after therapy. Manidipine significantly (p < 0.005) decreased mean systolic and diastolic BP during the entire 24 h, day-active and night-resting periods. The reduction in both systolic and diastolic BP was consistent throughout the whole day. Manidipine also significantly reduced the fractionated pressure-time indices of both systolic and diastolic BP consistently throughout the 24-h period. The circadian amplitude of BP in hypertensive patients, which was higher than that in normal reference subjects, was reduced by manidipine into the reference range. The acrophase of BP in hypertensive patients, which was similar to the reference value, was not altered by manidipine treatment. Manidipine did not change the mean HR during 24-h, day-active or night-resting periods. Therefore, once-daily manidipine monotherapy showed a consistent antihypertensive effect over 24 h and optimized the circadian amplitude of BP without an increase in HR.