Taking antihypertensives at bedtime nearly halves cardiovascular deaths when compared with morning dosing, study finds

Mayor, Susan

doi:10.1136/bmj.l6173

Cited by 3 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Administration of antihypertensive drugs before bedtime has been developed as a treatment strategy for BP management. In fact, some studies have demonstrated that compared with morning dosing, bedtime dosing reduced cardiovascular-related deaths by almost half (4,5). Numerous studies have examined the effects of taking antihypertensive medication before going to bed.…”

Section: Original Articlementioning

confidence: 99%

Bedtime administration of antihypertensive medication can reduce morning blood pressure surges in hypertensive patients: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background: The risk of cardiovascular and cerebrovascular events is the highest during the first several hours post-awakening in patients with hypertension. This is largely due to surges in morning blood pressure (BP). The current meta-analysis explored whether morning BP is affected by the timing of antihypertensive drug administration.Methods: Four medical databases were searched for clinical trials that examined the relationship between the timing of antihypertensive drug administration and morning BP levels. This meta-analysis compared morning BP surges in patients administered medication at bedtime versus patients administered medication during the day. Results:The random effects model demonstrated that bedtime administration of antihypertensive drugs reduced morning systolic blood pressure (SBP) by 1.17 mmHg [with 95% confidence interval (CI): −2.47 to 0.37; P=0.08), and reduced morning diastolic blood pressure (DBP) by 0.95 mmHg (95% CI: −2.03 to 0.13; P=0.08), compared with patients who were administered medication during the daytime hours. However, the results did not demonstrate statistical significance. There was strong heterogeneity in both morning SBP (I 2 =77.9% >50%, and Q test >0.1) and morning DBP results (I 2 =77.9% >50%, and Q test >0.1). The funnel plots showed no publication bias in this study.Discussion: Studies have shown that a 1 mmHg change was sufficient to reduce the risk of cardiovascularrelated deaths by 2.1%. Therefore, changing the time of taking antihypertensive medications may significantly reduce cardiovascular-associated mortality. There were certain limitations to this meta-analysis.First, the heterogeneity of the meta-analysis was strong, with undefined reasons. Second, the sample size was relatively small, and future studies involving larger cohorts are warranted to further assess the effects of bedtime antihypertensive medication on minimizing morning BP surges.

show abstract

Section: Original Articlementioning

confidence: 99%

Bedtime administration of antihypertensive medication can reduce morning blood pressure surges in hypertensive patients: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Recent NICE guidance1 was unable to take into account the recent Hygia chronotherapy trial, results of which were recently published in the European Heart Journal and reported in The BMJ 23. The trial showed that taking blood pressure tablets at night may be more beneficial, reporting a 45% risk reduction in cardiovascular morbidity and mortality.…”

mentioning

confidence: 99%

NICE guidance on hypertension in adults: take blood pressure tablets at night, measure blood pressure at home

Kittel

2019

BMJ

View full text Add to dashboard Cite

Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge

Zhang

Jin²,

Song

et al. 2021

Medicine

View full text Add to dashboard Cite

Background: It is well known that morning blood pressure surge increases the risk of myocardial events in the first several hours post-awakening. This meta-analysis was performed to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. Methods: Articles in 4 databases about clinical trials of ingestion time of antihypertensive drugs were searched and performed a meta-analysis to evaluate the different effects on morning blood pressure and absolute blood pressure (BP) reduction from baseline of between bedtime administration (experimental group) and morning awaking administration (control group). Results: The aim of this study is to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. Conclusions: The bedtime will provide evidence support for clinicians and patients for reducing morning blood pressure surge. Ethics and dissemination: This study does not require ethical approval.

show abstract

Taking antihypertensives at bedtime nearly halves cardiovascular deaths when compared with morning dosing, study finds

Cited by 3 publications

References 1 publication

Bedtime administration of antihypertensive medication can reduce morning blood pressure surges in hypertensive patients: a systematic review and meta-analysis

Bedtime administration of antihypertensive medication can reduce morning blood pressure surges in hypertensive patients: a systematic review and meta-analysis

NICE guidance on hypertension in adults: take blood pressure tablets at night, measure blood pressure at home

Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge

Contact Info

Product

Resources

About