Antihypertensive Drug Therapy in Consideration of Circadian Blood Pressure Variation*

J-MUBA was a large-scale clinical study which, for the first time in the world, evaluated the effects of an antihypertensive drug on circadian BP variation in more than 600 patients with hypertension. Although ACE inhibitors reportedly exert equal 24-hour antihypertensive effects on daytime and nighttime BP, and -blockers are reported to have weaker effects on nighttime BP than on daytime BP. However, clinical studies that have investigated the effects of these drugs on circadian BP variation have included only 20–30 subjects and have offered no detailed analyses of circadian BP variation, unlike J-MUBA. An outline of antihypertensive drug therapy in consideration of circadian BP variation has been given in this paper, including the results of J-MUBA. ABPM can provide additional useful information on BP that cannot be obtained by measurement of casual office BP. Increased clinical application of this technique based on further accumulation of study data is expected.