Journal
CHRONOBIOLOGY INTERNATIONAL
Volume 37, Issue 5, Pages 751-758Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/07420528.2020.1771356
Keywords
Ambulatory blood pressure monitoring; sleep-time blood pressure; bedtime hypertension chronotherapy; cardiovascular risk; hygia Chronotherapy Trial; mapec study; chronopharmacology; pharmacodynamics
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The main purpose of this commentary is to update, based on our extensive review of the published literature of the past 45 yrs, the differential therapeutic effects of hypertension medications of various classes and their combinations when ingested in the evening/at-bedtime versus in the morning/upon-awakening. Interestingly, revision of the currently available evidence on the differential circadian-time-dependent effects of hypertension medications of six different classes and their combinations indicates among the 137 published hypertension medication trials that evaluated blood pressure (BP)-lowering efficacy according to treatment-time, 112 (81.75%) documented significant better benefits by evening/bedtime compared to morning/awakening-scheduled therapy. The remaining 25 published trials found no treatment-time difference in effects; indeed, no single study has reported better benefits of the still conventional, but scientifically unjustified, morning than evening/at-bedtime treatment scheme.
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