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In the present study, published in Cardiovascular Drugs and Therapy, cilnidipine was given to 14 hospitalized patients with essential hypertension, and 24-hour ambulatory BP monitoring was performed. Once-daily administration of cilnidipine 1-3 weeks led to a reduction in the 24-hour average BP significantly from 149 +/- 4/88 +/- 2 mmHg to 141 +/- 3/82 +/- 2 mmHg without causing any change in the pulse rate. There was a noticeable reduction in ambulatory BP during the daytime (156 +/- 4/93 +/- 2 mmHg to 143 +/- 5/84 +/- 2 mmHg), while it was mild during nighttime (141 +/- 4/80 +/- 2 mmHg to 133 +/- 4/76 +/- 3 mmHg). The decrease in ambulatory BP over the whole day and during the nighttime was significantly correlated with the basal ambulatory BP levels. After segregating the patients into the high ambulatory BP (n = 7) and low ambulatory BP (n = 7) groups, the BP reduction was evident throughout the 24 hour period in the high ambulatory BP group, while it was mild and significant only during daytime in the low ambulatory BP group. Once-daily cilnidipine thus led to sufficient and prolonged reduction of BP without an increase in the pulse rate in patients with hypertension. Additionally, the efficacy of cilnidipine to decrease ambulatory BP may depend on the basal ambulatory BP level. Cilnidipine is therefore, a potential antihypertensive agent that may not cause an excessive reduction in BP or reflex tachycardia.