Key result
Morning ARB-based triple antihypertensive therapy is linked to a nondipping BP pattern.
Why the study?
Re-establishing dipping physiology significantly reduces cardiovascular events, but the effect of timing of fixed dose triple antihypertensive combinations on blood pressure control needed investigation.
Does the timing of fixed dose triple antihypertensive combinations affect blood pressure control and dipping physiology in patients with grade II hypertension?
RCT (n=116)
randomized
Does the timing of fixed dose triple antihypertensive combinations affect blood pressure control and dipping physiology in patients with grade II hypertension?
p-value: p=0.008
ARB-based fixed dose triple antihypertensive combinations may be more effective at ensuring dipping physiology when taken in the evening rather than the morning.
Morning ARB triple dosing may impair dipping; supports evening use and extends chronotherapy data to fixed-dose combinations in grade II hypertension.
INTRODUCTION: Re-establishing "dipping" physiology significantly reduces cardiovascular events. The aim was to investigate the effect of timing of fixed dose triple antihypertensive combinations on blood pressure (BP) control. METHODS: One hundred sixteen consecutive patients (62.7 ± 10.7 years, 38 men) with grade II hypertension were randomized into four groups. Group 1 and Group 2 patients were given angiotensin converting enzyme inhibitor-based triple antihypertensive pills to be taken in the morning or evening, respectively while Group 3 and Group 4 patients were given angiotensin receptor blocker (ARB) based triple antihypertensive pills to be taken in the morning or evening, respectively. All patients underwent 24-h ambulatory BP monitoring 1 month after the initiation of treatment. Nondipping pattern was significantly associated with taking ARB in the morning, even when adjusted by age, sex, and other comorbidities. CONCLUSION: Fixed dose triple antihypertensive drug combinations enable good BP control regardless of the timing of drug while ARB-based ones may be taken in the evening to ensure dipping physiology.
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İleri et al. (2023) conducted an RCT in Grade II hypertension (n=116). Fixed dose triple antihypertensive combinations vs. Alternative timing (morning vs evening) and base (ACEi vs ARB) was evaluated on Nondipping blood pressure pattern (p=0.008). Taking ARB-based fixed dose triple antihypertensive combinations in the morning was significantly associated with a nondipping blood pressure pattern (P=0.008).
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