SynthesisBMC cardiovascular disorders2021
Chronotherapy for morning blood pressure surge in hypertensive patients: a systematic review and meta-analysis.
Synthesis in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Chronotherapy in hypertension: a systematic review and meta-analysis of antihypertensive dosing timing on cardiovascular outcomes.Journal of human hypertension · 2026Pooled it
- Evening versus morning dosing regimen drug therapy for hypertension.The Cochrane database of systematic reviews · 2024Pooled it
- Bedtime vs Morning Antihypertensive Medications in Frail Older Adults: The BedMed-Frail Randomized Clinical Trial.JAMA network open · 2025Trial
- CONTROL-IHD Study: 24-h BP Control with Metoprolol-Telmisartan FDC in Hypertension and Stable Ischemic Disease.Advances in therapy · 2026Article
- Morning Blood Pressure and Adverse Pregnancy Outcomes in High-Risk Pregnancies.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The effect of evening vs. morning medication on morning blood pressure surge.Scientific reports · 2026Article
- The Clinical Significance of the Morning Blood Pressure Surge in Chronic Kidney Disease: A Systematic Review.Cureus · 2026Review
- Observational
- Interactions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- The Role of Circadian Rhythms in Stroke: A Narrative Review.Neurochemical research · 2024Review
- The Association between Diverticular Rebleeding and Early-Morning Blood Pressure and Surge: A Prospective Observational Trial.Digestion · 2023Observational
- Article
- Association of Morning Surge and Postexercise Heart Rate and Blood Pressure Recovery.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2022Article
- Prevalence and Clinical Characteristics including Patterns of Antihypertensive Drug Administration of the Different Home Blood Pressure Phenotypes in Treated Hypertensive Patients.International journal of hypertension · 2022Article
- Circadian disruption and human health.The Journal of clinical investigation · 2021Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe morning blood pressure surge (MBPS) is related to an exaggerated risk of cardiovascular diseases and mortality. With increasing attention on circadian change in blood pressure and extensive use of ambulatory blood pressure monitoring (ABPM), chronotherapy that administration of medication according to biological rhythm, is reported to improve cardiovascular outcomes. The aim of this study is to evaluate the influence of chronotherapy of antihypertensive drugs upon MBPS in hypertensive patients.
methodsA search strategy was applied in Ovid MEDLINE, EMBASE, Cochrane (Wiley) CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and the Chinese Biomedical literature database. No language and date restrictions. Randomized controlled trials (RCT) assessing the efficacy of evening and morning administration of the same medications in adult patients with primary hypertension were included.
resultsA total of ten trials, comprising 1724 participants with a mean age of 61 and 51% female, were included in this study. Combined analysis observed significant reduction of MBPS (- 5.30 mmHg, 95% CI - 8.80 to - 1.80), night-time SBP (- 2.29 mmHg, 95% CI - 4.43 to - 0.15), night-time DBP (- 1.63 mmHg, 95 %CI - 3.23 to - 0.04) and increase in night blood pressure dipping (3.23%, 95% CI 5.37 to 1.10) in evening dosage compared with traditional morning dosage of blood pressure-lowering drugs. No significant difference was found in the incidence of overall adverse effects (RR 0.65, 95% CI 0.30 to 1.41) and withdrawal due to adverse effects (RR 0.95, 95% CI 0.53 to 1.71).
conclusionsOur study suggested that evening administration of antihypertensive medications exerted better blood pressure-lowering effect on MBPS compared with conventional morning dosage. Safety assessment also indicated that the evening regimen did not increase the risk of adverse events. However, endpoint studies need to be carried out to confirm the significance and feasibility of this treatment regimen in clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.