Fimasartan for independent reduction of blood pressure variability in mild-to-moderate hypertension

Figures & data

Table 1 Baseline characteristics of the study population

	All (N=1,396)	Male (N=748)	Female (N=648)	P-value*
Age, mean ± SD (years)	56.17±10.00	55.47	56.98	0.0042
Body weight (kg), mean ± SD and mean	67.41±11.11	72.52	61.52	<0.0001
Height (cm)	162.91	168.80	156.11	<0.0001
Body mass index (kg/m^2)	25.32	25.42	25.21	0.2291
Current smoking, n (%)	249 (17.84)	231 (30.88)	18 (2.78)	<0.0001
Family history of CVD, n (%)	261 (18.70)	137 (18.32)	124 (19.14)	0.9239
History of hypertension (years)	4.13	4.23	4.02	0.4515
Duration of antihypertensive drug use (years)	3.87	3.92	3.80	0.6227
Current antihypertensive drug use, n (%)	946 (67.77)	516 (68.98)	430 (66.36)	0.2951
Diabetes, n (%)	245 (17.55)	150 (20.05)	95 (14.66)	0.0082
Ischemic heart disease, n (%)	96 (6.88)	54 (7.22)	42 (6.48)	0.5870
Stroke, n (%)	13 (0.93)	9 (1.20)	4 (0.62)	0.2807
Treatment type
Naïve,a n (%)	450 (32.23)	232 (31.02)	218 (33.64)	0.0035
Switch,b n (%)	597 (42.77)	302 (40.37)	295 (45.52)	–
Add-on,c n (%)	349 (25.00)	214 (28.61)	135 (20.83)	–

Notes:

* P-value between male and female.

a Patients without previous antihypertensive medication who received fimasartan.

b Patients who were switched from other antihypertensive drug to fimasartan.

c Patients who received fimasartan as an add-on antihypertensive therapy.

Abbreviation: CVD, cardiovascular disease.

Table 2 Changes in BP and heart rate after fimasartan treatment

	Baseline	3 months	Difference	P-value
Clinical BP, mean ± SD
c-SBP (mmHg)	142.39±17.00	127.32±13.14	15.08±18.36	<0.0001
c-DBP (mmHg)	88.03±11.35	79.37±9.40	8.66±11.38	<0.0001
c-Heart rate (bpm)	72.08±10.04	71.68±9.64	0.40±9.30	0.1055
Home BP, mean ± SD
m-SBP (mmHg)	138.80±19.81	127.32±16.72	11.49±19.33	<0.0001
m-DBP (mmHg)	83.26±13.16	76.62±11.32	6.64±11.98	<0.0001
m-Heart rate (bpm)	71.91±11.25	71.86±10.86	0.15±9.91	0.5866
e-SBP (mmHg)	137.57±20.53	126.33±17.06	11.18±19.73	<0.0001
e-DBP (mmHg)	81.35±13.29	75.07±11.44	6.31±12.28	<0.0001
e-Heart rate (bpm)	73.81±11.59	73.25±11.17	0.66±10.12	0.0184

Abbreviations: BP, blood pressure; bpm, beats per minute; c, clinical; DBP, diastolic blood pressure; e, evening; m, morning; SBP, systolic blood pressure.

Table 3 Changes in BP variability SD after fimasartan treatment

Variable	Baseline	3 months	Difference	P-value
SD of beat-to-beat BP in clinic, mean ± SD
SD of c-SBP (mmHg)	4.56±3.22	4.24±3.11	0.33±4.05	0.0026
SD of c-DBP (mmHg)	3.19±2.45	2.94±2.20	0.25±3.13	0.0024
SD of day-to-day BP at home, mean ± SD
SD of m-SBP (mmHg)	7.92±6.74	6.95±4.97	0.97±7.31	<0.0001
SD of m-DBP (mmHg)	5.30±3.98	4.83±3.23	0.47±4.67	0.0002
SD of e-SBP (mmHg)	8.39±6.94	7.16±5.38	1.16±6.89	<0.0001
SD of e-DBP (mmHg)	5.80±4.13	5.16±3.32	0.59±4.38	<0.0001

Abbreviations: BP, blood pressure; c, clinical; DBP, diastolic blood pressure; e, evening; m, morning; SBP, systolic blood pressure; SD, standard deviation.

Figure 1 Correlation between standard deviation (sd) of clinical systolic blood pressure (SBP) and sd of morning home SBP at baseline and after 3 months of fimasartan treatment.

Notes: (A) sd of morning home SBP versus sd of clinical SBP at baseline. (B) sd of morning home SBP versus sd of clinical SBP after fimasartan treatment. (C) sd of evening home SBP versus sd of clinical SBP at baseline. (D) sd of evening home SBP versus sd of clinical SBP after fimasartan treatment.
Abbreviations: b_SBPsd, sd of baseline SBP; m3_SBPsd, sd of clinical SBP after 3 months of fimasartan treatment; b_am_hSBPsd, sd of baseline morning home SBP; b_pm_hSBPsd, sd of baseline evening home SBP.

Figure 2 Changes in BPV and BP after fimasartan treatment.

Notes: (A) Changes in SD of beat-to-beat BP (BPV) in clinical and home (morning) settings after 3 months of fimasartan treatment. (B) Changes in clinical BP and home (morning) BP after 3 months of fimasartan treatment.
Abbreviations: BP, blood pressure; BPV, BP variability; c, clinical; m, morning; SBP, systolic blood pressure; SD, standard deviation.

Table 4 Linear regression analyses of factors associated with SD of clinical and home SBP at baseline

	SD of clinical SBP				SD of morning home SBP
	Simple regression		Multiple regression		Simple regression		Multiple regression
	β (SE)	P-value	β (SE)	P-value	β (SE)	P-value	β (SE)	P-value
Age (years)	0.02 (0.01)	0.0061	0.02 (0.01)	0.0065	0.05 (0.02)	0.0067	0.06 (0.02)	0.0005
Sex (females vs males [Ref])	0.14 (0.17)	0.4133	0.16 (0.22)	0.4737	1.07 (0.36)	0.0032	1.76 (0.44)	<0.0001
BMI (kg/m^2)	0.02 (0.03)	0.5668	0.01 (0.03)	0.6156	0.13 (0.06)	0.0246	0.10 (0.05)	0.0553
Smoking (current vs nonsmoker)	−0.26 (0.23)	0.2609	−0.20 (0.26)	0.4359	−0.06 (0.48)	0.9012	0.33 (0.51)	0.5172
Smoking (ex-smoker vs nonsmoker)	−0.17 (0.28)	0.5479	−0.20 (0.31)	0.5102	−0.52 (0.58)	0.3732	0.21 (0.61)	0.7287
Alcohol intake (vs no alcohol intake)	−0.05 (0.17)	0.7578	0.19 (0.21)	0.3635	−0.53 (0.36)	0.1421	0.30 (0.41)	0.4631
Diabetes	0.01 (0.23)	0.9616	−0.05 (0.23)	0.8124	0.78 (0.47)	0.0983	0.69 (0.46)	0.132
Clinic
Clinical SBP (mmHg)	0.02 (0.01)	<0.0001	0.02 (0.01)	<0.0001
Clinical HR (bpm)	−0.00 (0.01)	0.9686	0.00 (0.01)	0.7924
Home
Morning SBP (mmHg)					0.11 (0.01)	<0.0001	0.09 (0.01)	<0.0001
Morning HR (bpm)					0.13 (0.02)	<0.0001	0.09 (0.02)	<0.0001
	R^2=0.0191				R^2=0.1397

Abbreviations: BMI, body mass index; bpm, beats per minute; HR, heart rate; R², multiple regression coefficient of determination; SBP, systolic blood pressure; SD, standard deviation; SE, standard error.

Table 5 Linear regression analyses of factors associated with changes in SD of clinical and morning home SBP after fimasartan treatment

	Simple regression		Multiple regression*
	β (SE)	P-value	β (SE)	P-value	R^2
Changes in SD of clinical SBP
Change in clinical SBP (mmHg)	0.03 (0.01)	<0.0001	0.04 (0.02)	0.0268	0.0213
Change in clinical HR (bpm)	−0.00 (0.01)	0.7058	−0.00 (0.01)	0.7055	0.0179
Changes in SD of morning home SBP
Change in morning SBP (mmHg)	0.09 (0.01)	<0.0001	0.08 (0.03)	0.0258	0.0672
Change in morning HR (bpm)	0.15 (0.02)	<0.0001	0.08 (0.02)	0.0006	0.0762

Note:

* These models are adjusted for age, sex, body mass index, and change in mean arterial pressure (DBP + [SBP−DBP]/3), where DBP is diastolic blood pressure.

Abbreviations: bpm, beats per minute; HR, heart rate; R², multiple regression coefficient of determination; SBP, systolic blood pressure; SD, standard deviation; SE, standard error.