Chronotherapy in hypertension

Chronotherapy may minimize side effects (fatigue and drowsiness), and maximize beneficial effects of antihypertensive medications. Ingestion of antihypertensives can affect circadian patterns of BP, but whether this translates into an effect on clinical outcomes is unknown. In a recent open label study, bedtime dosing demonstrated a significant reduction in risk for a composite outcome of cardiovascular death, myocardial infarction, and stroke. Each 5-mmHg decrease in the mean sleep-time systolic BP was associated with a 14% reduction in the risk for cardiovascular events. Thus, at least one antihypertensive at bedtime reduces the risk for cardiovascular events