SynthesisHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2026
Bedtime Versus Morning Dosing of Anti-hypertensives: A GRADE-Assessed Meta-Analysis of Randomized Controlled Trials with Trial Sequential Evidence.
Synthesis in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe timing of anti-hypertensive medication may influence cardiovascular outcomes and blood pressure control, yet the evidence remains inconclusive.
aimWe conducted a meta-analysis to compare the effects of bedtime versus morning dosing of anti-hypertensives on mortality, cardiovascular events, and ambulatory blood pressure.
methodsWe conducted a meta-analysis of randomized controlled trials (RCTs) comparing bedtime versus morning administration of antihypertensive therapy. A comprehensive literature search was performed in PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases up to June 2025. Pooled risk ratios (RRs) were calculated for categorical outcomes, and mean differences (MDs) for continuous variables. All statistical analyses were performed using R version 4.3.3. PROSPERO registration ID: CRD420251113957.
resultsPooled analysis of six RCTs with 49,983 patients was included. Bedtime dosing of anti-hypertensive medications resulted in a lower incidence of heart failure (1.3% vs. 2.0%; RR 0.63, 95% CI 0.47-0.85) but not myocardial infarction (1.4% vs. 1.6%; RR 0.87, 95% CI 0.64-1.17), stroke or transient ischemic attack (0.9% vs. 1.3%; RR 0.71, 95% CI 0.49-1.05), all-cause mortality (2.6% vs. 3.1%; RR 0.75, 95% CI 0.53-1.06), or cardiovascular mortality (1.0% vs. 1.5%; RR 0.52, 95% CI 0.22-1.21). For blood pressure, bedtime dosing significantly reduced evening systolic blood pressure (MD - 4.71 mmHg, 95% CI - 6.64 to - 2.78) and evening diastolic blood pressure (MD - 1.66 mmHg, 95% CI - 1.92 to - 1.40), with no significant differences observed in morning readings.
conclusionBedtime administration of anti-hypertensive medications may be associated with reduction in MACE and heart failure incidence. No significant effect was observed in mortality, myocardial infarction, or stroke.
Indexed as
Identifiers
41186654What OpenQuestion holds
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.