Is there a BP benefit of changing the time of aspirin administration in treated hypertensive patients?

Abstract

It does not appear useful to advise patients with long-standing hypertension to modify timing of aspirin intake in order to reduce BP values.

The Effects of Different Aspirin Dosing Frequencies and the Timing of Aspirin Intake in Primary and Secondary Prevention of Cardiovascular Disease: A Systematic Review

“…The search strategy identified 4,272 records; 28 studies were eligible for inclusion and informed the analysis (see Figure ). Twelve studies investigated the effects of aspirin when administrated once‐daily in the morning / after awakening vs. in the evening / at bedtime; 12 studies compared aspirin administration once‐daily with two or more times daily; and four studies compared once‐daily vs. alternate‐day (or less frequent) aspirin dosing. Table shows the main study characteristics.…”

“…In 9/12 studies, 24‐hour or 48‐hour mean ambulatory blood pressure measurements (ABPM) were reported . Of those, four parallel RCTs conducted by the same research group favored aspirin administration in the evening, with most results being statistically significant (see Figure ).…”

“…Morning vs. evening administration. Twelve studies (see Table 1) were identified: nine were RCTs (four parallel 19,25,28,29 and five crossover 26,27,30,31,33 ) and three nonrandomized controlled trials (one parallel 24 and two crossover 32,34 ). Studies were heterogeneous in terms of population (untreated or treated hypertension, CVD), duration of treatment (from 5-7 days to 1 year), and outcome (BP, PFT, or cutaneous flushing).…”

“…In 9/12 studies, 24-hour or 48-hour mean ambulatory blood pressure measurements (ABPM) were reported. 19,[25][26][27][28][29][30]33,34 Of those, four parallel RCTs 19,25,28,29 conducted by the same research group favored aspirin administration in the evening, with most results being statistically significant (see Figure 2). All four studies included untreated grade 1 (mild) hypertensives or prehypertensives that were on average much younger compared to the populations in the crossover trials discussed below.…”

“…The four remaining crossover studies 26,27,30,34 found that the effect of aspirin was not influenced by the timing (see Figure 2). The populations included in these studies were treated hypertensives (with comorbidities such as diabetes/renal failure 27 and obesity 34 ) or individuals with already established CVD. 26,30 Patients in these studies were older compared to those in the parallel RCTs, and on comedication for hypertension.…”