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Impact of timing of antihypertensive treatment on mortality: An observational study from the Spanish Ambulatory Blood Pressure Monitoring Registry
dc.contributor.author | De La Sierra, Alejandro | |
dc.contributor.author | Ruilope, Luis M. | |
dc.contributor.author | Martínez-Camblor, Pablo | |
dc.contributor.author | Vinyoles, Ernest | |
dc.contributor.author | Gorostidi, Manuel | |
dc.contributor.author | Segura, Julián | |
dc.contributor.author | Williams, Bryan | |
dc.date.accessioned | 2024-06-19T04:52:51Z | |
dc.date.available | 2024-06-19T04:52:51Z | |
dc.date.issued | 2024 | |
dc.identifier | 10.1097/HJH.0000000000003581 | |
dc.identifier.issn | 02636352 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12728/11383 | |
dc.description.abstract | Background 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. | es_ES |
dc.description.sponsorship | Lacer Laboratories; Spanish Society of Hypertension; National Institute for Health and Care Research, NIHR; University College London Hospitals Biomedical Research Centre, UCLH BRC | es_ES |
dc.language.iso | en | es_ES |
dc.publisher | Lippincott Williams and Wilkins | es_ES |
dc.subject | ambulatory blood pressure monitoring | es_ES |
dc.subject | antihypertensive treatment | es_ES |
dc.subject | bedtime dosing | es_ES |
dc.subject | cardiovascular mortality | es_ES |
dc.subject | chronotherapy | es_ES |
dc.subject | mortality | es_ES |
dc.title | Impact of timing of antihypertensive treatment on mortality: An observational study from the Spanish Ambulatory Blood Pressure Monitoring Registry | es_ES |
dc.type | Article | es_ES |