Journal article
Efficacy and safety of nighttime dosing of antihypertensives: review of the literature and design of a pragmatic clinical trial
The journal of clinical hypertension (Greenwich, Conn.), Vol.16(2), pp.115-121
02/2014
DOI: 10.1111/jch.12238
PMCID: PMC4091949
PMID: 24373519
Abstract
Blood pressure exhibits circadian variability, and nighttime blood pressure is one of the best predictors of cardiovascular (CV) events. Adults with hypertension who lack a nighttime dipping pattern are at particularly high risk. Several studies have found that bedtime dosing of antihypertensive agents reduces sleep blood pressure and improves the dipping pattern in nondippers. One small study and 2 substudies of diabetes and chronic kidney disease suggest that bedtime dosing of ≥ 1 antihypertensives significantly reduced CV events. A Cochrane review of 5 studies found no difference in adverse events between morning and evening dosing. However, several evaluations in ophthalmology have found that nocturnal arterial hypotension precipitated ocular vascular disorders such as ischemic optic neuropathy. Some authors have suggested that additional studies of nighttime dosing of antihypertensive agents that evaluate CV events need to be conducted. The authors describe a randomized controlled pragmatic trial that is being planned at the University of Iowa and Duke University. Patients with hypertension and other comorbid conditions will be randomized to either continue morning dosing of all antihypertensive agents or to switch their nondiuretic medications to bedtime dosing. Patients will be followed for 36 to 42 months. This study will determine whether nighttime dosing reduces CV risk when compared with traditional morning dosing of antihypertensive agents.
Details
- Title: Subtitle
- Efficacy and safety of nighttime dosing of antihypertensives: review of the literature and design of a pragmatic clinical trial
- Creators
- Barry L Carter - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA; Iowa City Veterans Administration, Iowa City, IAElizabeth A ChrischillesGary RosenthalBrian M GryzlakEric L EisensteinMark W Vander Weg
- Resource Type
- Journal article
- Publication Details
- The journal of clinical hypertension (Greenwich, Conn.), Vol.16(2), pp.115-121
- DOI
- 10.1111/jch.12238
- PMID
- 24373519
- PMCID
- PMC4091949
- NLM abbreviation
- J Clin Hypertens (Greenwich)
- ISSN
- 1751-7176
- eISSN
- 1751-7176
- Publisher
- United States
- Grant note
- #5U18HSO16094 / PHS HHS UH2 AT007784 / NCCIH NIH HHS F32 HL009184 / NHLBI NIH HHS U18 HS016094 / AHRQ HHS 1-UH2AT007784-01 / NCCIH NIH HHS R01 HL09184 / NHLBI NIH HHS
- Language
- English
- Date published
- 02/2014
- Academic Unit
- Pharmacy; Epidemiology; Psychological and Brain Sciences; Pharmacy Practice and Science; Injury Prevention Research Center; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9983996060202771
Metrics
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