Chronotherapy of hypertension: current state of the problem and prospects

Abstract

Chronotherapy for hypertension has been a topic of debate over the past decade. A number of studies up to 2019 suggested that prescribing drugs in the evening has advantages compared to morning, both in terms of normalization of blood pressure and its circadian rhythm, as well as in terms of the risk of adverse outcomes. Some of these studies were not designed for such an analysis, and some have significant limitations that make their interpretation difficult. The results of the HARMONY and TIME studies published in the last 2 years did not confirm any advantage of taking drugs in the evening compared to the morning, but showed its safety. Selection of antihypertensive therapy should be guided by antihypertensive efficacy, duration and stability of the effect, as well as medical adherence. Therefore, a single intake of double or triple fixed-dose combination of long-acting agents at hours convenient for the patient is optimal.