Considering chronotype to improve hypertension management

Tomáš Baka; Darlynn M. Rojo‐Wissar; Fedor Šimko

doi:10.1016/j.eclinm.2024.102768

July 26, 2024EClinicalMedicineOpen Access

Considering chronotype to improve hypertension management

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Why the study?

Does aligning antihypertensive medication dosing time with patient chronotype reduce non-fatal myocardial infarction or stroke in patients with arterial hypertension?

Structured PICO

Does aligning antihypertensive medication dosing time with patient chronotype reduce non-fatal myocardial infarction or stroke in patients with arterial hypertension?

P

Population

Patients with arterial hypertension evaluated in the Chronotype sub-study of the Treatment in Morning versus Evening (TIME) study (with roughly 50% having an intermediate chronotype)

I

Intervention

Antihypertensive medication dosing time aligned with the patient's chronotype (eveningness chronotype dosed in the evening and morningness chronotype dosed in the morning)

C

Comparator

Antihypertensive medication dosing time misaligned with the patient's chronotype

O

Outcome

Non-fatal myocardial infarction (MI) or strokehard clinical

Limitations

Low non-fatal stroke incidence in the sub-study
Need for confirmation in larger prospective clinical trials with more diverse populations and elevated cardiovascular risk to broaden generalisability
Need for more rigorously controlled selection of patients and consideration of biological time instead of arbitrary hourly time intervals
Lack of ambulatory blood pressure monitoring to detect isolated office hypertension or masked hypertension and control for hemodynamic effects

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Implication

This commentary highlights proof-of-concept evidence from the TIME Chronotype sub-study suggesting that aligning antihypertensive medication dosing time with a patient's endogenous chronotype may reduce the risk of non-fatal myocardial infarction.

Abstract

Hypertension is the dominant risk factor for cardiovascular pathologies, yet it remains poorly controlled. Chronotherapy, an approach considering circadian (i.e., ∼24-h) rhythms in physiology and pathology, could contribute additional benefit to hypertension management.

Discussion

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Cite This Study

Baka et al. (2024) studied this question.

synapsesocial.com/papers/6a7098d41556b380a226fe5b https://doi.org/10.1016/j.eclinm.2024.102768

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Considering chronotype to improve hypertension management

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Considering chronotype to improve hypertension management

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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