Evening administration of antihypertensive drugs: filling a knowledge gap

Abstract

The increasing availability of out-of-office blood pressure (BP) monitoring techniques, in particular of ambulatory BP monitoring (ABPM) and of BP monitoring at home (HBPM) allows the physicians to get a more detailed information on the efficacy of antihypertensive drug coverage over different periods of the day in nonhospitalized patients [1,2]. Based on this information physicians may now identify the best timing of drug administration to attain BP control over subperiods of the day and night when it is not adequate. This ‘chronotherapeutic’ approach is theoretically justified by the data showing that inadequate control of BP may be particularly detrimental during night-time and morning hours [3–5] as well as by the available studies showing the superiority of out-of-office over office BP in predicting cardiovascular outcomes also in treated hypertensive patients [6,7].