June 26, 2020Journal of Hypertension
Circadian variations in blood pressure and their implications for the administration of antihypertensive drugs: is dosing in the evening better than in the morning?
Key result
Evening BP dosing offers no benefit over morning dosing for BP control or CV events.
Why the study?
It has been proposed to prescribe at least one antihypertensive medication at bedtime to improve nocturnal blood pressure control and reduce cardiovascular events, prompting an examination of supporting data.
Does evening administration of antihypertensive drugs improve blood pressure control and reduce cardiovascular events compared to morning administration in patients with hypertension?
Population
Patients treated for hypertension
Comparison
Prescribing blood pressure-lowering drugs at bedtime vs morning dosing
Design
Review
Authors
Discussion
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Member takes
Implication
Does not support routine switch to evening antihypertensive dosing; leaves question open pending ongoing trials.
Structured PICO
Does evening administration of antihypertensive drugs improve blood pressure control and reduce cardiovascular events compared to morning administration in patients with hypertension?
P
Population
Patients treated for hypertension
I
Intervention
Administration of antihypertensive medication at bedtime (evening)
C
Comparator
Administration of antihypertensive medication in the morning
O
Outcome
Quality of blood pressure control, prevention of target organ damage, and reduction of cardiovascular events
Current evidence does not support a routine switch to evening administration of antihypertensive medications to improve cardiovascular outcomes, pending results from ongoing trials.
Cite This Study
Burnier et al. (2020) conducted a review in Hypertension. Evening administration of antihypertensive drugs vs. Morning administration was evaluated on Quality of BP control, prevention of target organ damage, or reduction of cardiovascular events. Evening administration of blood pressure-lowering drugs provides no convincing evidence of significant advantage over morning dosing for BP control or reduction of cardiovascular events.