Why the study?
Chronotherapy for hypertension has been debated, with earlier studies suggesting evening dosing advantages while recent trials like HARMONY and TIME found no advantage over morning dosing.
Does prescribing antihypertensive drugs in the evening improve blood pressure control and reduce adverse outcomes compared to morning dosing in patients with hypertension?
Does prescribing antihypertensive drugs in the evening improve blood pressure control and reduce adverse outcomes compared to morning dosing in patients with hypertension?
Evening dosing of antihypertensive medications offers no significant advantage over morning dosing, suggesting patients should take long-acting combinations at their most convenient time to maximize adherence.
Chronotherapy for hypertension has been a topic of debate over the past decade. A number of studies up to 2019 suggested that prescribing drugs in the evening has advantages compared to morning, both in terms of normalization of blood pressure and its circadian rhythm, as well as in terms of the risk of adverse outcomes. Some of these studies were not designed for such an analysis, and some have significant limitations that make their interpretation difficult. The results of the HARMONY and TIME studies published in the last 2 years did not confirm any advantage of taking drugs in the evening compared to the morning, but showed its safety. Selection of antihypertensive therapy should be guided by antihypertensive efficacy, duration and stability of the effect, as well as medical adherence. Therefore, a single intake of double or triple fixed-dose combination of long-acting agents at hours convenient for the patient is optimal.
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Kobalava et al. (2023) conducted a review in Hypertension. Evening dosing of antihypertensive drugs vs. Morning dosing was evaluated.
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