What are the time-related effects of evening versus morning administration of once-daily antihypertensive drug monotherapy on all-cause mortality, cardiovascular morbidity and blood pressure (BP) reduction in patients with primary hypertension?
Meta-analysis showed significant heterogeneity across trials. Most trials had a risk of bias in at least two of several key criteria.
Variations in blood pressure levels display circadian rhythms. The morning surge in blood pressure is known to increase the risk of myocardial events in the first several hours post-awakening. Guidelines have recommended using once-daily, long-acting antihypertensive drugs to provide more consistent 24-hour BP control, reduce BP variability, and improve adherence to therapy.1