The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review

To investigate the effect of night-time BP-lowering drug treatment on the risk of major CVD and mortality, we systematically reviewed randomized controlled trials comparing night-time versus morning dosing. Two studies were found relevant to the clinical question (the MAPEC and Hygia trials). They w...

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Main Authors: Ho, Chau L.B., Chowdhury, Enayet, Doust, J., Nelson, M.R., Reid, Christopher
Format: Journal Article
Language:English
Published: SPRINGERNATURE 2021
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1136372
http://hdl.handle.net/20.500.11937/93773
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author Ho, Chau L.B.
Chowdhury, Enayet
Doust, J.
Nelson, M.R.
Reid, Christopher
author_facet Ho, Chau L.B.
Chowdhury, Enayet
Doust, J.
Nelson, M.R.
Reid, Christopher
author_sort Ho, Chau L.B.
building Curtin Institutional Repository
collection Online Access
description To investigate the effect of night-time BP-lowering drug treatment on the risk of major CVD and mortality, we systematically reviewed randomized controlled trials comparing night-time versus morning dosing. Two studies were found relevant to the clinical question (the MAPEC and Hygia trials). They were similar in study design and population and were conducted by the same study group. As the Hygia trial had more power with a significantly larger sample size, we did not perform a meta-analysis. Both studies reported a reduction of ~50% in major CVD events and all-cause mortality with night-time dosing and a reduction of 60% in CVD mortality. The results from these studies support the implementation of night-time BP-lowering drug treatment in the prevention of CVD and mortality. However there is an on-going discussion on the validity and methodology of MAPEC and Hygia trials, the interpretation of the results should be cautious. Stronger evidence is needed prior to changing clinical practice. Questions that remain to be answered relate to the generalisability of the results across different populations at different levels of BP related risk and the importance of morning versus evening timing of medication on CVD prevention as determined though a well-designed randomised controlled trial.
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spelling curtin-20.500.11937-937732024-01-09T07:29:36Z The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review Ho, Chau L.B. Chowdhury, Enayet Doust, J. Nelson, M.R. Reid, Christopher Science & Technology Life Sciences & Biomedicine Peripheral Vascular Disease Cardiovascular System & Cardiology HYPERTENSIVE PATIENTS ACTIVE TREATMENT DRUG-THERAPY TIME RATIONALE EVENTS DESIGN CHRONOTHERAPY PLACEBO REGIMEN Antihypertensive Agents Blood Pressure Blood Pressure Determination Cardiovascular Diseases Humans Humans Cardiovascular Diseases Antihypertensive Agents Blood Pressure Determination Blood Pressure To investigate the effect of night-time BP-lowering drug treatment on the risk of major CVD and mortality, we systematically reviewed randomized controlled trials comparing night-time versus morning dosing. Two studies were found relevant to the clinical question (the MAPEC and Hygia trials). They were similar in study design and population and were conducted by the same study group. As the Hygia trial had more power with a significantly larger sample size, we did not perform a meta-analysis. Both studies reported a reduction of ~50% in major CVD events and all-cause mortality with night-time dosing and a reduction of 60% in CVD mortality. The results from these studies support the implementation of night-time BP-lowering drug treatment in the prevention of CVD and mortality. However there is an on-going discussion on the validity and methodology of MAPEC and Hygia trials, the interpretation of the results should be cautious. Stronger evidence is needed prior to changing clinical practice. Questions that remain to be answered relate to the generalisability of the results across different populations at different levels of BP related risk and the importance of morning versus evening timing of medication on CVD prevention as determined though a well-designed randomised controlled trial. 2021 Journal Article http://hdl.handle.net/20.500.11937/93773 10.1038/s41371-020-00469-1 English http://purl.org/au-research/grants/nhmrc/1136372 SPRINGERNATURE restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
HYPERTENSIVE PATIENTS
ACTIVE TREATMENT
DRUG-THERAPY
TIME
RATIONALE
EVENTS
DESIGN
CHRONOTHERAPY
PLACEBO
REGIMEN
Antihypertensive Agents
Blood Pressure
Blood Pressure Determination
Cardiovascular Diseases
Humans
Humans
Cardiovascular Diseases
Antihypertensive Agents
Blood Pressure Determination
Blood Pressure
Ho, Chau L.B.
Chowdhury, Enayet
Doust, J.
Nelson, M.R.
Reid, Christopher
The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title_full The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title_fullStr The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title_full_unstemmed The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title_short The effect of taking blood pressure lowering medication at night on cardiovascular disease risk. A systematic review
title_sort effect of taking blood pressure lowering medication at night on cardiovascular disease risk. a systematic review
topic Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
HYPERTENSIVE PATIENTS
ACTIVE TREATMENT
DRUG-THERAPY
TIME
RATIONALE
EVENTS
DESIGN
CHRONOTHERAPY
PLACEBO
REGIMEN
Antihypertensive Agents
Blood Pressure
Blood Pressure Determination
Cardiovascular Diseases
Humans
Humans
Cardiovascular Diseases
Antihypertensive Agents
Blood Pressure Determination
Blood Pressure
url http://purl.org/au-research/grants/nhmrc/1136372
http://hdl.handle.net/20.500.11937/93773