Abstract-Previous studies on the potential influence of aspirin on blood pressure have not taken into consideration the chronopharmacological effects of nonsteroidal anti-inflammatory drugs. This pilot study investigates the effects of aspirin on blood pressure in untreated hypertensive patients who received aspirin at different times of the day according to their rest-activity cycle. We studied 100 untreated patients with mild hypertension (34 men and 66 women), 42.5Ϯ11.6 (meanϮSD) years of age, randomly divided into 3 groups: nonpharmacological hygienic-dietary recommendations; the same recommendations and aspirin (100 mg/d) on awakening; or the same recommendations and aspirin before bedtime. Blood pressure was measured every 20 minutes during the day and every 30 minutes at night for 48 consecutive hours before and after 3 months of intervention. The circadian pattern of blood pressure in each group was established by population multiple-component analysis. After 3 months of nonpharmacological intervention, there was a small, nonsignificant reduction of blood pressure (Ͻ1.1 mm Hg; PϾ0.341). There was no change in blood pressure when aspirin was given on awakening (Pϭ0.229). A highly significant blood pressure reduction was, however, observed in the patients who received aspirin before bedtime (decrease of 6 and 4 mm Hg in systolic and diastolic blood pressure, respectively; PϽ0.001). Results indicate a statistically significant administration time-dependent effect of low-dose aspirin on blood pressure in untreated patients with mild hypertension. The influence of aspirin on blood pressure demonstrated in this study indicates the need to quantify and control for aspirin effects in patients using this drug in combination with antihypertensive medication. Key Words: antihypertensive agents Ⅲ blood pressure monitoring, ambulatory Ⅲ heart rate Ⅲ hypertension, mild Ⅲ drug therapy Ⅲ circadian rhythm T here is an extensive literature on the effects of acetylsalicylic acid (ASA, or aspirin), one of the most commonly consumed nonsteroidal anti-inflammatory drugs (NSAID), mainly in the prevention of cardiovascular events. 1-3 Although some of these studies reported average values of office blood pressure (BP) measurements for the patients before and after long-term administration of ASA or placebo, the study of a possible effect from ASA on BP was not a primary objective. In fact, the effect of ASA on BP was evaluated only in a few small studies. 4 -6 It has been reported that NSAID may increase BP both in normotensive and hypertensive subjects. 4,[7][8][9] The effects appear more marked in hypertensive subjects under treatment. 4,7 The mechanisms whereby NSAID may increase BP are not fully understood, nor it is known whether the increase in BP is a long-term effect. In any event, the dose of ASA regularly used to show anti-inflammatory effects is markedly larger than the dose used as anticoagulant 10 and recommended for prevention of cardiovascular events. [1][2][3] ASA use in hypertensive patients is expected to inc...