These properties are thought to arise because azelnidipine hardly activates the sympathetic nervous system. We investigated the suppressive effect of azelnidipine on BP measured at the clinic and at home, morning hypertension, and pulse rates, using data from the Azelnidipine Apoptosis Compound Library screening Treatment for Hypertension Open-label Monitoring in the Early morning (At-HOME) Study, which was carried

out as a special survey for post-marketing surveillance in daily clinical settings. 2 Subjects and Methods 2.1 Subjects This study was conducted according to Article 14-4 (re-examination) of the Pharmaceutical Affairs Act, Japan, and in compliance with Good Post-marketing Study Practice (GPSP). For a list of participating centers [in Japanese], see the electronic supplementary material. The study included patients who met all of the following requirements at baseline when they started buy CA3 taking the study drug, azelnidipine (Calblock® tablets; Daiichi Sankyo Co., Ltd.): (i) outpatient with hypertension; (ii) no previous use of the study drug; (iii) clinic BP measurement within 28 days prior to baseline; and (iv) morning home BP measurement using an electronic brachial-cuff device at least two times on separate dates within 28 days prior to baseline. The study was conducted using the central enrollment method, in which patients from

contracted medical institutions nationwide were registered by the enrollment center within 14 days after the baseline date. The enrollment period was one year from May 2006, and the planned number of cases to be investigated was 5,000. The study drug was administered at the investigator’s CX-5461 in vivo discretion, according to the dosage and administration instructions in the package insert, with no limit set on dose increases or decreases, or on pretreatment or concomitant use of antihypertensive drugs. The standard observation period was 16 weeks, during which the study drug was administered, except in cases of withdrawal or dropout. 2.2 Ribonucleotide reductase Outcome Measures We investigated the patient

characteristics, study drug dosage, study drug compliance, pretreatment with antihypertensive drugs, use of concomitant drugs, clinical course, clinical examinations, conditions of BP measurement at home, and adverse events occurring during or after treatment with the study drug. In order to investigate the variables under actual conditions, the method of BP measurement and the timing of dosing and BP measurement during the observation period were not specified in the study protocol, and these decisions were left to the investigators. Investigators assessed safety on the basis of the results of patient interviews and clinical examinations. 2.3 Subject Inclusion in Analysis Sets The following enrolled patients were excluded from the safety analysis population (Fig.