Abstract
PurposeTime of drug administration may significantly influence its effect. The aim of the present study was to investigate the effect of ASA (administrated in the morning or in the evening) on the anti-hypertensive effect and diurnal blood pressure profile in the high-risk group of cardiovascular patients.MethodsAll patients (n = 114) had been diagnosed with coronary heart disease and arterial hypertension prior to the enrolment and had been treated with 75 mg per day of ASA in the morning. The patients were randomly assigned to one of the two study groups receiving 75 mg of ASA per day in a single antiplatelet therapy for 3 months in the morning (n = 58) or in the evening (n = 56). The control group (n = 61) consisted of patients with arterial hypertension but without coronary heart disease, not receiving ASA. In all the patients, during each visit, clinical blood pressure (BP) and ambulatory blood pressure measurements (ABPM) were performed.ResultsThere was a significant reduction in 24-h BP and blood pressure at night in the ASA group evening group compared with the ASA morning group and the control group.ConclusionsThe present study demonstrated that compared with the use of ASA in the morning, its administration in the evening may lead to favourable drop in the ABPM and an improvement of the diurnal profile in the high-risk group of cardiovascular patients who are not naïve to ASA.
Highlights
Acetylsalicylic acid (ASA) is one of the most commonly used drugs in the secondary prevention of coronary arterial disease [1,2,3]
This is due to circadian rhythms, which are governed by a network of hierarchical master clocks present at various locations in the brain and peripheral tissues [23]. Such circadian variation has been demonstrated for factors such as serum nitric oxide, prostaglandin, plasma renin activity, angiotensin II, and angiotensinconverting enzyme [24,25,26]. Taking this into consideration it could be hypothesised whether administration of ASA in the morning or evening may differentially affect the change in the diurnal blood pressure profile
The present study demonstrated the clinic blood pressure drop after 3 months of evening ASA administration in patients with arterial hypertension coronary heart disease who were already taking ASA
Summary
Acetylsalicylic acid (ASA) is one of the most commonly used drugs in the secondary prevention of coronary arterial disease [1,2,3]. It is well established that time of drug administration may profoundly influence the effects it is aimed to exert, and this phenomenon includes anti-hypertensive drugs [7, 21, 22] This is due to circadian rhythms, which are governed by a network of hierarchical master clocks present at various locations in the brain and peripheral tissues [23]. Such circadian variation has been demonstrated for factors such as serum nitric oxide, prostaglandin, plasma renin activity, angiotensin II, and angiotensinconverting enzyme [24,25,26] Taking this into consideration it could be hypothesised whether administration of ASA in the morning or evening may differentially affect the change in the diurnal blood pressure profile. In most cases, ASA is taken in one daily dose in the morning hours [28, 29]
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