Impact of timing of antihypertensive treatment on mortality: An observational study from the Spanish Ambulatory Blood Pressure Monitoring Registry

dc.creatorDe La Sierra, Alejandro
dc.creatorRuilope, Luis M.
dc.creatorMartínez-Camblor, Pablo
dc.creatorVinyoles, Ernest
dc.creatorGorostidi, Manuel
dc.creatorSegura, Julián
dc.creatorWilliams, Bryan
dc.date2024-06-19T04:52:51Z
dc.date2024-06-19T04:52:51Z
dc.date2024
dc.date.accessioned2024-07-17T21:15:18Z
dc.date.available2024-07-17T21:15:18Z
dc.identifier10.1097/HJH.0000000000003581
dc.identifier02636352
dc.identifierhttps://hdl.handle.net/20.500.12728/11383
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/9509833
dc.descriptionBackground and aims:Whether bedtime versus morning administration of antihypertensive therapy is beneficial on outcomes is controversial. We evaluated the risk of total and cardiovascular mortality in a very large observational cohort of treated hypertensive patients, according to the timing of their usual treatment administration (morning versus evening).Methods:Vital status and cause of death were obtained from death certificates of 28 406 treated hypertensive patients (mean age 62 years, 53% male individuals), enrolled in the Spanish Ambulatory Blood Pressure Monitoring (ABPM) Registry between 2004 and 2014. Among the 28 406 patients, most (86%) received their medication exclusively in the morning; whilst 13% were treated exclusively in the evening or at bedtime. Follow-up was for a median of 9.7 years and 4345 deaths occurred, of which 1478 were cardiovascular deaths.Results:Using Cox-models adjusted for clinical confounders and 24-h SBP, and compared with patients treated in the morning (reference group), all-cause mortality [hazard ratio 1.01; 95% CI 0.93-1.09) and cardiovascular mortality (hazard ratio 1.04; 95% CI 0.91-1.19) was not significantly different in those receiving evening medication dosing. The results were consistent in all the subgroups of patients analysed.Conclusion:In this very large observational study, morning versus bedtime dosing of antihypertensive medication made no difference to the subsequent risk of all-cause or cardiovascular mortality. These findings are in accordance with results from a recent randomized controlled trial and do not support the hypothesis of a specific beneficial effect of night-time antihypertensive treatment dosing on risk of all-cause or cardiovascular death. © 2024 Lippincott Williams and Wilkins. All rights reserved.
dc.descriptionLacer Laboratories; Spanish Society of Hypertension; National Institute for Health and Care Research, NIHR; University College London Hospitals Biomedical Research Centre, UCLH BRC
dc.formatapplication/pdf
dc.languageen
dc.publisherLippincott Williams and Wilkins
dc.subjectambulatory blood pressure monitoring
dc.subjectantihypertensive treatment
dc.subjectbedtime dosing
dc.subjectcardiovascular mortality
dc.subjectchronotherapy
dc.subjectmortality
dc.titleImpact of timing of antihypertensive treatment on mortality: An observational study from the Spanish Ambulatory Blood Pressure Monitoring Registry
dc.typeArticle


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