{"id":"4a94fba848cd","type":"article","url":"https://hartvaat.nl/2018/10/01/ochtend-versus-avonddosering-van-antihypertensiva-gerandomiseerde-crossover-tria/","title":"Ochtend- versus avonddosering van antihypertensiva: gerandomiseerde crossover-trial","title_en":"Randomized Crossover Trial of the Impact of Morning or Evening Dosing of Antihypertensive Agents on 24-Hour Ambulatory Blood Pressure.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.118.11101","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.118.11101","authors":["Neil R Poulter","Christos Savopoulos","Aisha Anjum","Martha Apostolopoulou","Neil Chapman","Mary Cross","Emanuela Falaschetti","Spiros Fotiadis","Rebecca M James","Ilias Kanellos","Matyas Szigeti","Simon Thom","Peter Sever","David Thompson","Apostolos I Hatzitolios"],"significance":7,"published":"2018-10-01","source_date":"2018-10-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/bloeddrukmeting-thuismeting-abpm/"],"congress":"","summary_en":"This randomized crossover trial showed no significant difference between morning and evening dosing of antihypertensive medications on 24-hour ambulatory blood pressure, providing early evidence that dosing time does not matter — a finding later confirmed by the larger TIME trial.","created":"2026-07-03T10:27:30Z","updated":"2026-07-03T13:26:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde crossover-trial die ochtend- versus avonddosering van antihypertensiva vergeleek op 24-uurs ambulante bloeddruk. Relevant voor het chronotherapeutische debat.","abstract_original":"Some data suggest that nocturnal dosing of antihypertensive agents may reduce cardiovascular outcomes more than daytime dosing. This trial was designed to evaluate whether ambulatory blood pressure monitoring levels differ by timing of drug dosing. Patients aged 18 to 80 years with reasonably controlled hypertension (≤150/≤90 mm Hg) on stable therapy of ≥1 antihypertensive agent were recruited from 2 centers in London and Thessaloniki. Patients were randomized to receive usual therapy either in the morning (6 am-11 am) or evening (6 pm-11 pm) for 12 weeks when participants crossed over to the alternative timing for a further 12 weeks. Clinic blood pressures and a 24-hour recording were taken at baseline, 12, and 24 weeks and routine blood tests were taken at baseline. The study had 80% power to detect 3 mm Hg difference in mean 24-hour systolic blood pressure (α=0.05) by time of dosing. A 2-level hierarchical regression model adjusted for center, period, and sequence was used. Of 103 recruited patients (mean age, 62; 44% female), 95 patients (92%) completed all three 24-hour recordings. Mean 24-hour systolic and diastolic blood pressures did not differ between daytime and evening dosing. Similarly, morning and evening dosing had no differential impact on mean daytime (7 am-10 pm) and nighttime (10 pm-7 am) blood pressure levels nor on clinic levels. Stratification by age (≤65/≥65 years) or sex did not affect results. In summary, among hypertensive patients with reasonably well-controlled blood pressure, the timing of antihypertensive drug administration (morning or evening) did not affect mean 24-hour or clinic blood pressure levels. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT01669928."}