[Antihypertensives: better evenings than mornings]

Ned Tijdschr Geneeskd. 2013;157(34):A6022.
[Article in Dutch]

Abstract

In a reasonably large proportion of patients who take antihypertensive drugs (10-30%), hypertension appears to be therapy resistant; even the use of three antihypertensives does not lower the blood pressure sufficiently. The average nocturnal blood pressure is a better predictor of cardiovascular events than blood pressure measured during the day. Antihypertensives have a stronger effect on nocturnal blood pressure when taken in the evening rather than in the morning. The exact mechanism of this has not yet been unravelled, but randomised, non-blinded studies suggest that this so-called chronotherapy does indeed lower cardiovascular risk in certain groups. The authors regard this as a promising strategy for patients with therapy-resistant hypertension in whom a nocturnal blood pressure dip does not occur.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Chronotherapy*
  • Circadian Rhythm / physiology*
  • Humans
  • Hypertension / drug therapy*
  • Treatment Outcome

Substances

  • Antihypertensive Agents