{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:23:23Z","timestamp":1765733003590,"version":"3.48.0"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,8,21]]},"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We previously demonstrated that a calcium channel blocker, azelnidipine, improves left ventricular relaxation in patients with hypertension and diastolic dysfunction in a multicentre, Clinical impact of Azelnidipine on Left VentricuLar diastolic function and OutComes in patients with hypertension (CALVLOC) trial. The objectives of the present subanalysis were to investigate the differences in diastolic function in hypertensive patients with and without diabetes, and the efficacy of azelnidipine on diastolic function among them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Subanalysis of a prospective single-arm multicentre study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      228 hypertensive patients with normal ejection fraction and impaired left ventricular relaxation (septal e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity &lt;8\u2005cm\/s on echocardiography) enrolled for CALVLOC trial. They were divided into two groups based on presence or absence of diabetes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Administration of 16\u2005mg of azelnidipine for 8\u2005months (range 6\u201310\u2005months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>\n                      Septal e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity before and at the end of the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Whereas patients with diabetes (n=53, 23.2%) had lower systolic blood pressure (BP) than patients without diabetes (155\u00b117 vs 161\u00b116\u2005mm\u2005Hg, p=0.03), they had lower e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity (5.7\u00b11.5 vs 6.1\u00b11.4\u2005cm\/s, p=0.04) at baseline. Azelnidipine decreased BP and heart rate, and increased e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity similarly in patients with diabetes (5.7\u00b11.5 to 6.3\u00b11.5\u2005cm\/s, p=0.0003) and without diabetes (6.1\u00b11.4 to 6.9\u00b11.4\u2005cm\/s, p&lt;0.0001). Increase in e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity was not influenced by presence of diabetes, and patients with diabetes still had lower e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity after treatment (p=0.006). There was a significant correlation between increase in e\n                      <jats:sup>\u2032<\/jats:sup>\n                      velocity and decrease in systolic BP (R=0.25, p=0.0001), which was not influenced by diabetes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comorbid diabetes could impair left ventricular relaxation independently in patients with hypertension, which might not be improved solely by BP lowering.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006136","type":"journal-article","created":{"date-parts":[[2014,9,30]],"date-time":"2014-09-30T20:17:47Z","timestamp":1412108267000},"page":"e006136","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in left ventricular relaxation after azelnidipine treatment in hypertensive patients with diabetes: subanalysis of a prospective single-arm multicentre study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-1521","authenticated-orcid":false,"given":"Katsuomi","family":"Iwakura","sequence":"first","affiliation":[{"name":"Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University, Graduate School of Medicine, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhisa","family":"Ishii","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Kansai Electric Power Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoo","family":"Date","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Medicine, Ibaraki Iseikai Hospital, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiko","family":"Nagano","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Iwasa Dai-ichi Hospital, Gifu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Takiuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Higashi-Takarazuka Satoh Hospital, Takarazuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,9,30]]},"reference":[{"key":"2025121409210791000_4.9.e006136.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn596"},{"key":"2025121409210791000_4.9.e006136.2","unstructured":"Yancy C , Jessup M , Bozkurt B , et al . 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines. 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