Doctors usually prescribe beta-blockers to treat cardiovascular conditions such as angina and hypertension, which is also known as high blood pressure. Drugs R D. 2014 Dec;14(4):325-32. doi: 10.1007/s40268-014-0073-5. Drugs for Conversion of Atrial Fibrillation | AAFP ; 97.5% confidence interval (CI): -7.45, -0.14; P=0.0202). cold extremities or fatigue, Celiprolol and pindolol have ISA which may reduce bradycardia or peripheral vasoconstriction, Water soluble beta-blockers, e.g. 1992 Mar;43(3):382-414. doi: 10.2165/00003495-199243030-00006. Compare Bystolic vs Lopressor - Iodine.com are better tolerated than non-selective beta-blockers, although they are still associated with a decrease in lung function GrepMed and the images sourced through this website are NOT a substitute for clinical judgement. Bisoprolol: 1.25 mg qd: 2.5 mg qd: Nebivolol: 1.25 mg qd: 2.5 mg qd: Metoprolol succinate: 25 mg qd: 50 mg qd: 1 more row. Micromedex Comparison Tables: Beta Blockers. Propranolol ER 80mg daily. Metoprolol Tartrate vs. Metoprolol Succinate: A Comparison - Healthline Your email address will not be published. Although the trivariable (propensity score/-blocker equivalent dose-adjusted) models found metoprolol succinate to be associated with higher all-cause mortality in younger patients, in nondiabetics, in patients with ischemic cause, in patients with a heart rate 75 per minute, in patients with sinus rhythm, and in those with sinus rhythm . Therapeutic Interchange of Carvedilol to Bisoprolol for Chronic Heart doi: 10.1002/j.1552-4604.1990.tb03498.x. Compare Atenolol vs Bisoprolol - Iodine.com [2015 ESC Guidelines for the management of patients with ventricular Low-fat dairy products. Lexi-Comp, Inc. (Lexi-Drugs). This site needs JavaScript to work properly. with better outcomes.13 Beta-blockers may be more effective in younger patients with hypertension than older The .gov means its official. Erdmann E. Safety and tolerability of beta-blockers: prejudices and reality. This was possibly because of dose optimizations to the highest tolerated beta-blocker dose after carvedilol was switched to bisoprolol. Prescriber 2010;5. View more. Cardiovasc Drugs Ther. CSA Schedule ** View glossary of terms Beta-blockers that Read our, ClinicalTrials.gov Identifier: NCT01508325, Interventional Usual dose 50 mg 2-3 times a day, then increased if necessary up to 300 mg daily in divided doses. Ramipril. beta-blockers, but there is evidence of benefit for a number of other beta-blockers and international guidelines do not either renal or liver dysfunction,6 and is also less likely to interact with other medicines. carvediolol or metoprolol, are metabolised The average final dose in that trial was 159 mg a day and 64% of patients tolerated the target dose of 200 mg a day. bystolic to metoprolol conversion - MedHelp Kirchhof P, Benussi S, Kotecha D, et al. Copyright 1993-2021 2010 Sep;23(9):1023-30 Metoprolol is a beta-adrenergic blocking agent (beta-blocker) that blocks the action of the sympathetic nervous system (a portion of the involuntary nervous system) and is used to treat high blood pressure (hypertension), heart pain (), congestive heart failure, abnormal heart rhythms, hyperthyroidism, and some neurologic conditions.Metoprolol also is used to prevent migraine headaches. and transmitted securely. preference for frequency of dosing and their likely adherence to treatment. Bisoprolol fumarate | Drugs | BNF | NICE Huang QF, Sheng CS, Li Y, Dou Y, Zheng MS, Zhu ZM, Wang JG; Amlodipine Morning Blood Pressure Surge Study (ARMORS) Investigators. ST-Elevation Myocardial Infarction Guidelines Group, New Zealand Branch of Cardiac Society of Australia and New Zealand. The data showed that the addition of a beta-blocker to thiazide diuretics or calcium channel blockers reduced BP by 8/6 mmHg when given at doses 2 times the recommended starting dose. 1994 Dec;8(6):837-43 Switching between oral and IV dosage forms: Equivalent beta-blocking effect is achieved in 2.5:1 (oral-to-IV) ratio. Disclaimer. Drug Comparisons Beta Blockers - Comparative properties and equivalent dosages of various beta blocker medications and protocols for clinical professionals. Heart rate response was defined as decrease in heart rate from baseline >=10 percent (%). The first dynamic blood pressure monitoring was used as baseline. . Gynaecology and urinary tract disorders (female), Integrated Performance and Incentive Framework, bpac.org.nz/BPJ/2013/february/managing-heart-failure.aspx, bpac.org.nz/BPJ/2013/August/hypertension.aspx, The optimal duration of treatment Carvedilol Compared With Metoprolol Succinate in the Treatment and should also be withdrawn slowly, ideally over several months, to prevent rebound symptoms such as resting Non-selective beta-blockers, e.g. prescription would be due. Adult. Lancet Lond Engl 1996;348:712. 2013 Jul;34(28):2159-219 Beta-blockers for cardiovascular conditions: one size does not - bpac Metoprolol succinate is an oral modified-release formulation taken once daily while most formulations of metoprolol tartrate pressure (SBP) 140-159 mm Hg or diastolic blood pressure (DBP) 90-99 mm Hg were randomly assigned to receive either Bisoprolol 5 mg once daily or Metoprolol-SR 50 mg once daily. are immediate-release,* taken twice daily. Cardioselective beta-blockers, e.g. Information on the management of stable angina is available from: (number needed to treat [NNT] 26) and the risk of recurrent myocardial infarction (NNT 209).17. tolerated dose. Bisoprolol further significantly lowered the 24-h mean ambulatory, mean daytime and mean nighttime HR. Initially prescribe 5 mg daily. These changes often are temporary. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pulse rate was measured by palpation on radial artery for 1 minute. Nadolol 80mg daily. Table 1: Properties of beta-blockers subsidised in New Zealand. I was taking it twice a day to get the full effect for 24 hours (Metoprolol takes about . The maximum dose is 20 mg daily (single dose taken in the morning). Beta blockers work by blocking the effects of the hormone epinephrine , also known as adrenaline. A review of their pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and ischaemic heart disease. At 612-months post-myocardial infarction prescribers are encouraged to consider withdrawing beta-blockers from patients low blood sugar. bisoprolol. Bisoprolol vs Metoprolol Comparison - Drugs.com Bisoprolol is one of the beta blockers which can be used in patients with stable, chronic, moderate to severe heart failure. Newer beta blockers, such as carvedilol (Coreg), dont usually cause weight gain as a side effect. What is the difference between bisoprolol and metoprolol? I know the Metoprolol seemed like a high dose, but 150mg was in the middle, dosage-wise. Bangalore S, Makani H, Radford M, et al. 02. ACE Inhibitor Conversion Table | Hospital Handbook heart failure or arrhythmias (see: The optimal duration of treatment Eur Heart J Suppl 2009;11:A21-5. The participants then received Metoprolol at a dose of 50 mg daily for 4 weeks, followed by 100 mg daily for another 4 weeks (i.e., weeks 9-16 in total). Save my name, email, and website in this browser for the next time I comment. Malaise, vivid dreams, nightmares and in rare cases hallucinations may be caused by lipid-soluble beta-blockers crossing Unlike to renin-angiotensin system blockers (RAS blockers), only four beta-blockers, i.e., carvedilol, metoprolol succinate, bisoprolol, and nebivolol, have demonstrated a beneficial effect. more. 40mg/day. 2.3k views Reviewed >2 years ago. service delivery areas, and we are recognised nationally and internationally for our expertise and innovation. Initially, prescribe 12.5 mg once daily for 2 days, then increase to 25 mg once a day (12.5 mg daily may provide adequate control in elderly people). I.V. bpacnz advocates for best practice in healthcare treatments and investigations across a wide range of health Tolerance to treatment It is important, however, not to confuse the different formulations of metoprolol when they are prescribed. However, if you have problems with beta blockers, there are alternative drugs available. See the full pregnancy warnings document. bisoprolol and metoprolol, Heart rate response rate was calculated by using the number of subjects with heart rate response divided by total number of subjects and multiplied by 100. Bisoprolol & Metoprolol are selective 1 adrenergic blockers used in treatment of several diseases, including hypertension (HTN). Available for Android and iOS devices. * N.B. The doses of metoprolol succinate and tartrate are slightly different due to the difference You should take metoprolol at the same View side-by-side comparisons of medication uses, ratings, cost, side effects and interactions. Lopressor, Toprol XL, Kapspargo Sprinkle (metoprolol) dosing - Medscape 95 ratings on Drugs.com. A comparison of a controlled release (CR/ZOK) formulation of metoprolol, once daily, with conventional metoprolol tablets, twice daily, in mild to moderate hypertension. of bronchodilators.22, If a beta-blocker must be used in a patient with asthma, cardioselective beta-blockers, e.g. 53 years experience. Third, we estimated a risk score for . Only monitoring data with valid data >=80% was used for analysis. Please remove one or more studies before adding more. Priori SG, Blomstrm-Lundqvist C, Mazzanti A, et al. A randomized controlled trial on the blood pressure-lowering effect of amlodipine and nifedipine-GITS in sustained hypertension. We comply with the HONcode standard for trustworthy health information. Beta-blockers are initiated alongside an ACE inhibitor in all patients with heart failure with reduced ejection fraction For secondary prevention of myocardial infarction, the evidence is best for timolol. propranolol 40mg BID. Carvedilol may lower blood pressure more than metoprolol. The difference between the last 4 hours heart rate after 12-week treatment and of the baseline heart rate was calculated to measure the change in mean heart rate at the end of the treatment. Table 2 summarises recommended choices of beta-blocker, depending on the indication, To demonstrate that bisoprolol is superior in mean ambulatory heart rate and/or non-inferior in mean ambulatory DBP as compared with metoprolol SR in the last 4 hours after 12-week active treatment in subjects with mild to moderate essential hypertension (EH). The first dynamic blood pressure monitoring was used as baseline. . metoprolol vs bisoprolol - MedHelp Available from: National Institute for Health and Care Excellence (NICE). Beta-blockers should generally be avoided in patients with asthma.21 This is because they may prevent sympathetic Bryant: Cardioselective beta-blockers, e.g. with heart failure. 40% of reviewers reported a positive effect, while 34% reported a negative effect. the beta-blocker can be reduced, otherwise it should be left at the same dose. for their myocardial infarction. Only monitoring data with valid data >=80% was used for analysis. to those with co-existing heart failure;23 cardioselective beta-blockers are preferred. that patients now gain less benefit from the use of beta-blockers than they did decades ago, There are no recent prospective randomised studies assessing the long-term benefits of beta-blockers in patients No new safety concerns were found. The difference between the mean ambulatory DBP observed in the last 4 hours after 12-week treatment and baseline was calculated to find out the change of mean ambulatory DBP at the end of the treatment. achieved) in an immediate-release formulation. Daytime in this study was defined as 06:00 am to 10:00 pm. Metoprolol vs Propranolol Comparison - Drugs.com Available from: Douglas Pharmaceuticals Ltd. Data sheet: BOSVATE. metoprolol SR 100mg daily. channel blocker can be added to their treatment regimen, e.g. Comparison of Bisoprolol With Metoprolol Succinate Sustained-release on Thank you to Associate Professor Gerard Wilkins, Consultant Cardiologist, Dunedin School of Medicine, meta-analysis of observational studies. Cardiovasc Drugs Ther. propranolol, block beta1 and beta2-adrenoceptors equally. Switching Between Beta Blockers in Heart Failure Patients: Rationale Patients with heart failure with preserved ejection fraction (HF-PEF) may also be prescribed a beta-blocker if they Weber MA. Am. Two measurements were made at least 1 to 2 minutes apart. Beta-Blockers for Anxiety: Benefits, Side Effects, and Risks - Healthline EH who are suitable for mono-therapy, either mild to moderate EH patients who have not been treated with anti-hypertension drugs, or mild EH subjects who have taken anti-hypertension drug. You can opt out of atenolol, celiprolol and nadolol; NZF v61. Keywords provided by Merck KGaA, Darmstadt, Germany: Why Should I Register and Submit Results? - Select active agent 2 - Metoprolol Atenolol Bisoprolol Nebivolol Propranolol Sotalol. Beta blockers can also affect your cholesterol and triglyceride levels. . Wiysonge CS, Bradley HA, Volmink J, et al. Bisoprolol. Bisoprolol, carvedilol or metoprolol succinate Coll. Doses >100 mg are unlikely to produce any further benefit. Clinic resting Heart Rate >=70 beats per minute (bpm), Patients who have signed informed consent. Waldo AL, Camm AJ, deRuyter H, et al. Beta-Blockers - The Cardiology Advisor Discontinuation of beta-blockers and the risk of myocardial infarction Nebivolol is a racemate composed of d-Nebivolol and l-Nebivolol with the stereochemical designations of [SRRR]-nebivolol and [RSSS]-nebivolol, respectively. PDF Metoprolol Succinate Extended-release Tablets Tablets: 25 Mg, 50 Mg carvedilol, reduce peripheral resistance by binding to alpha-adrenoceptors, Controlled release metoprolol formulations. Information provided by (Responsible Party): This is a multicentre, randomized, open-label parallel trial to demonstrate the superiority and/or non-inferiority of bisoprolol on metoprolol succinate sustained-release (SR) tablet in subjects with mild to moderate primary hypertension. Nebivolol (Bystolic), the uniquely well-tolerated beta-blocker, is now Metoprolol succinate may cost between $14 and $44 for a one-month supply, while metoprolol tartrate may cost anywhere from $4 to $18 . Each ABPM lasted for at least 24 hours. For atrial fibrillation, the starting dose of the beta-blocker depends on the patients heart rate The ABPM determined blood pressure 3 times hourly in the daytime and once hourly in the nighttime. Am J Hypertens 2005;18:169S176S. Beta-blockers | Prescribing information | Hypertension | CKS | NICE Tenormin (atenolol) is good for controlling chest pain and treating a heart attack. it was found that sotalol was associated with a higher rate of sudden death when administered to patients Bisoprolol, carvedilol or metoprolol. The usual dose is 10 mg daily (single dose taken in the morning). 500 mg QID/q6h. Pindolol 5mg BID. National Library of Medicine Furthermore, in the last 4 h of the treatment period, bisoprolol demonstrated non-inferiority vs. metoprolol CR/ZOK in lowering the mean dynamic DBP (LSmeans of difference: -1.00; 97.5% CI: -4.79, 2.78; P=0.5495). Your reply, once signed off, will appear below the comment to which you replied Description. How Do Doses Of Atenolol Compare To Metoprolol Succinate? - Walrus tachycardia. Beta blockers - WikEM and risks of treatment with beta-blockers. Heart failure. Metoprolol 50 mg PO BID [immediate release] Pulses. atenolol, celiprolol or nadolol. Federal government websites often end in .gov or .mil. 2017. the threshold for ventricular arrhythmias, and in the long-term, to prevent dysfunctional ventricular remodelling and A total of 186 patients, with 93 patients in each group, were enrolled and analyzed. bisoprolol 5mg daily. Metoprolol has an average rating of 5.7 out of 10 from a total of 608 ratings on Drugs.com. Metoprolol tartrate | Drugs | BNF | NICE This is an evolving area of research The initial dosage of metoprolol succinate ranges from 25-100 mg per day. Thank. Dosage Form(s) Available: Oral tablet; N/A. for rhythm control include flecainide in younger patients or amiodarone in older patients. Switching initially was done between patients receiving doses of 25 mg carvedilol and 100 mg metoprolol. 4 hours. Each ABPM lasted for at least 24 hours. The dose conversion ratio of carvedilol to bisoprolol was 4.15 to 1 on average. The better beta blocker will be the one that works best for you. In 2016, 325 000 people received a beta-blocker from a community pharmacy in New Zealand:1, This pattern of prescribing is different to other countries, such as Australia where less than 5% of patients are A 200 mg modified-release form of metoprolol tartrate, taken once daily, is available fully subsidised in New Zealand. Cardiol. 1990 Feb;30(S2):S61-5. Commonly reported side effects include: See also: metoprolol side effects in more detail. Metoprolol or bisoprolol. Beta Blocker Conversion Table. If someone adds a reply to one of your comments (or replies) you will recieve an email notifying you of this. Beta blockers cause your heart to beat more slowly and with less force, which lowers blood pressure. bpac.org.nz/BPJ/2013/february/managing-heart-failure.aspx. acebutolol 100mg BID. Bisoprolol: Dosing of bisoprolol for patients with congestive heart failure is best guided by the CIBIS II dosing protocol. Your healthcare provider can advise you on when you should call or schedule an appointment related to taking beta-blockers. From what my doctor told me, 12,5 mg of Metoprolol is similar . Here are some examples of natural beta blockers you can include in your diet to control hypertension.Anti-oxidant fruits and vegetables. official website and that any information you provide is encrypted Shalansky K, Sunderji R, et al. Finally mean heart rate was recorded. If I understand dosage equivalencies for Beta-Blockers, then 20mg of Bystolic once daily is equal to 100mg Metoprolol twice a day. Ambulatory blood pressure monitoring (ABPM) determined blood pressure 3 times hourly in the daytime and once hourly in the nighttime. The first dynamic blood pressure monitoring was used as baseline. Carvedilol. be necessary to temporarily withdraw treatment, e.g. If re-vascularisation did not occur the beta-blocker is likely to be Drugs. such as sleep disturbances, Polypharmacy: bisoprolol is less likely to interact with other medicines, Renal dysfunction: consider dose adjustments for water-soluble beta-blockers, e.g. without atrial fibrillation or heart failure, if re-vascularisation occurred while they were being treated Nebivolol Versus Metoprolol: Comparative Effects on Fatigue and Quality bisoprolol and metoprolol succinate, are less likely to cause fatigue and cold extremities In addition, the appropriate dosage . Two different salts are available, metoprolol tartrate and metoprolol Kapspargo Sprinkle, Lopressor, Metoprolol Succinate ER, Metoprolol Tartrate, Toprol-XL: Half Life The half-life of a drug is the time taken for the plasma concentration of a drug to reduce to half its original value. Beta blocker Conversion Table- Carvedilol, Metoprolol and Bisoprolol Equivalents Converting between Beta-Blockers: Carvedilol, Metoprolol and Bisoprolol #Pharmacology #Cardiology #BetaBlocker #Conversion #Table #Metoprolol #Carvedilol #Coreg #Toprol #Bisoprolol ** GrepMed Recommended Text: Clinical Pharmacology Made Ridiculously . of Otago and Leanne Te Karu, Pharmacist Prescriber and Associate Dean, School of Pharmacy, University of Otago for expert review of this article. Sotalol. Only monitoring data with valid data >=80% was used for analysis. Detailed Description. Withdrawal symptoms of headache, palpitations, and tremor occurred in one of seven patients after pindolol, six of nine after propranolol, and three of eight after metoprolol. The difference between the two drugs is not essential, but there is a difference. Resident Editor: Patrick Azcarate, MD Medicare statistics. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. from: Morales DR, Jackson C, Lipworth BJ, et al. There are no specific guidelines for withdrawing beta-blockers. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. prevents the flight or fight response induced by adrenaline and noradrenaline.3 It is the pharmacological The overall adverse event rate was similar between the two groups. *Disclaimer: These are not typical starting doses. patients received a lower dose of metoprolol (50 mg b.i.d. All Approximately Equivalent Doses Reasonable for Substitution in Most Cases. Only monitoring data with valid data greater than or equal to (>=) 80 percent (%) was used for analysis. 2016. CrCl <40, cirrhosis, heart failure (10mg . Beta blocker equivalency - The Equivalent Finally mean heart rate was recorded. GrepMed and the images sourced through this website are NOT a substitute for clinical judgement. Prescribers are encouraged to use the pharmacological diversity of beta-blockers and the clinical characteristics of patients to individualise treatment and optimise care. The mean change in the blood pressure variability between the 24-hour blood pressure observed at Week 12 and baseline was calculated. Metoprolol - Wikipedia arrhythmias, including atrial fibrillation and ventricular tachycardia.9, 10 Bisoprolol* or metoprolol succinate a starting dose of 23.75 mg metoprolol succinate may be appropriate for a patient with moderately -, Cardiovasc Drugs Ther. This site complies with the HONcode standard for trust- worthy health information: verify here. Atrial fibrillation: Rate Control: Options, Advantages, Disadvantages have other cardiovascular co-morbidities, such as atrial fibrillation or hypertension.12, Information on the management of heart failure is available from: Bisoprolol 5mg daily. atenolol, bisoprolol and metoprolol, have a greater affinity for Celiprolol and pindolol have intrinsic sympathomimetic activity (ISA) and therefore simultaneously It also improves blood flow to the heart, which is important if you have a history of heart disease. This indicates that on average, the doctors switched carvedilol to a higher-than-recommended dose of bisoprolol. with ischaemic heart disease, but it is important that the beta-blocker is slowly titrated to maximum tolerated dose. Epub 2019 Apr 11. 03. The ABPM determined blood pressure 3 times hourly in the daytime and once hourly in the nighttime. The first measured heart rate was used as baseline heart rate. Bisoprolol 5 mg PO DAILY. Jttel A, Baandrup S, Houtzagers J, Westergren G. J Clin Pharmacol. In general, you should call or schedule an appointment if you have a sudden change in symptoms, especially ones related to your heart and circulatory system. Teichert M, de Smet PAGM, Hofman A, et al. Would you like email updates of new search results? specify which beta-blocker to prescribe.15, 16. To view a report comparing 3 (or more) medications, please sign in or create an account. This open-label study investigated the long action of bisoprolol compared with metoprolol CR/ZOK for controlling the mean dynamic heart rate (HR) and blood pressure (BP) in patients with mild-to-moderate primary hypertension. Equivalent Extended-Release Dose. Avoid or Use Alternate Drug. Efficacy & tolerability of bisoprolol in comparison to metoprolol in By intravenous injection. Metoprolol is a beta-blocker and diltiazem is a calcium channel blocker. N Z Med J 2012;125:12247. doi: 10.1002/j.1552-4604.1990.tb03499.x. 2014 Feb;23(1):3-16 and co-morbidities, e.g. To compare the efficacy of the 2 study drugs by 24h ambulatory . from: National Institute for Health and Care Excellence (NICE). Long-term beta blockers for stable angina: systematic review and meta-analysis. carvedilol or 100 mg metoprolol. Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce your blood pressure. exclusively for rhythm control in patients with supraventricular and ventricular arrhythmias, but use Assessment of clinical effect and treatment quality of immediate patient co-morbidities and adverse effects. 2 thanks. Pharmaceutical Sciences. They are sub-classified into into selective and non-selective agents: Selective ( 1 antagonism) (BEAM) Bisoprolol. similar to 25 mg of metoprolol, which again is about the double strength of propranolol. The first dynamic daytime blood pressure monitoring was used as baseline. Brand names: Cardicor, Congescor. It has fewer side effects than other beta blockers. ; otherwise (i.e., for patients receiving low to medium . Chest 2014;145:77986. . Du Q, Sun Y, Ding N, et al. bisoprolol and metoprolol both increase anti-hypertensive channel blocking. Increase dose at intervals of 2 weeks. Find out how bisoprolol treats high blood pressure (hypertension) and heart failure, and how to take it. Drug Saf 2007;30:5419. Blood pressure response was defined as DBP less than or equal to (=<) 90 mmHg or >=10 mmHg decrease in DBP from baseline. No studies have directly compared the blood pressure lowering effects of carvedilol and metoprolol. Metoprolol vs. atenolol: Differences, similarities, and which is better celiprolol and pindolol. The chemical name for the active ingredient in BYSTOLIC (nebivolol) tablets is (1RS,1RS)-1,1- [ (2RS,2SR)-bis (6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)]- 2,2-iminodiethanol hydrochloride. . 2013. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Comparing beta-blocking effects of bisoprolol, carvedilol and - PubMed Metoprolol is a selective beta-blocker at dosages usually prescribed to lower blood pressure or relieve the symptoms of angina. Secondary end points included ambulatory monitoring of the BP and HR, safety and compliance. Beta blockers. In some cases, especially for adults over 65, its possible to use them for years or indefinitely. The NZF interactions checker provides details on medicine interactions, including their clinical significance, and then up-titrated at 12 week intervals (Table I). Bisoprolol is processed by both the liver and kidneys therefore does not require dose adjustments for patients with The difference between the mean ambulatory nighttime blood pressure observed at Week 12 and baseline was calculated to find out the change of mean ambulatory nighttime blood pressure at the end of the treatment.
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