The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Nighttime administration of antihypertensive medication: a review of chronotherapy in hypertension

  • Hyun-Jin Kim (Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Sang-Ho Jo (Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • Received : 2023.07.19
  • Accepted : 2023.09.01
  • Published : 2024.03.01
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Abstract

Hypertension remains a global health concern because of suboptimal blood pressure control despite advancements in antihypertensive treatments. Chronotherapy, defined as evening or bedtime administration of medication based on biological rhythms, is emerging as a potential strategy to improve blood pressure control and treatment outcomes. Clinical trials have investigated the potential effects of nighttime administration of antihypertensive medication in the improvement of 24 hours blood pressure control and reduction of cardiovascular risk. Implementing chronotherapy in clinical practice could have significant implications in enhancing blood pressure control and improving clinical outcomes in patients with hypertension, particularly those with resistant hypertension. However, recent trials have reported contradictory results, causing confusion in real-world practice. Herein we review, analyze, and critique the current evidence and propose suggestions regarding the clinical application and future directions of chronotherapy.

Keywords

Acknowledgement

This work was supported by grant from Ministry of Trade, Industry and Energy of Korea (no. 20016181).

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