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Should clinical practice change to bedtime administration of antihypertensive?
  1. Jian-Yu E
  1. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Dr Jian-Yu E, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2103, USA; je1{at}jhu.edu

https://doi.org/10.1136/bmjebm-2020-111435

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    Chronotherapy provides a new option to optimise hypertension and reduce cardiovascular risks based on the circadian profile of blood pressure.1 A recent Hygia trial reported taking bedtime antihypertensives reduced cardiovascular disease (CVD) risk by 45% compared with ingestion of medications on awakening.2 However, two key points related to the design and reporting of this trial should be considered in developing guidelines for optimal timing of antihypertensive use.

    The Hygia trial reported that there was no treatment-time difference in prevalence of all adverse events and sleep time hypotension. Unexpectedly, they did …

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    Footnotes

    • Contributors J-YE: conceptualisation, investigation, methodology, resources, visualisation, writing-original draft, writing-review and editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.