Premium
Evening versus morning dosing regimen drug therapy for chronic kidney disease patients with hypertension in blood pressure patterns: a systematic review and meta‐analysis
Author(s) -
Wang Caixia,
Ye Yuqiu,
Liu Chunyong,
Zhou Yongming,
Lv Linsheng,
Cheng Cailian,
Li Shaomin,
Lou Tanqi,
Liu Xun
Publication year - 2017
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13490
Subject(s) - medicine , evening , dosing , regimen , blood pressure , kidney disease , morning , physics , astronomy
Background Evening dosing regimen drug therapy on blood pressure ( BP ) control is used widely, but its clinical benefits and preservation or re‐establishment of the normal 24‐h BP dipping pattern in chronic kidney disease ( CKD ) patients is not known. Aims To investigate the effect of an evening dosing regimen of antihypertensive drugs on BP patterns of CKD patients with hypertension. Methods A systematic review was conducted by searching PUBMED , EMBASE , ASN‐ONLINE , the Cochrane Library and the reference lists of relevant articles of published papers. All trials designed to evaluate the effects of evening versus morning dosing regimen drug therapy for CKD patients with hypertension were included. Meta‐analysis was performed using random or fixed effects models. Results Five randomised controlled trials and one comparative study, including 3732 patients, met the inclusion criteria. Compared with morning dosing regimen drug therapy, evening administration of antihypertensive medication was associated with a significant reduction of 40% in non‐dipper BP patterns (risk ratio ( RR ), 95% CI , (0.43, 0.84)). We noted a significant decrease in nocturnal systolic blood pressure ( SBP ) ( MD −3.17 mmHg , 95% CI (−5.41, −0.94)), a significant reduction in nocturnal diastolic blood pressure ( DBP ) ( MD −1.37 mmHg , 95% CI (−2.05, −0.69)) and a significant increase in awake SBP ( MD 1.15 mmHg , 95% CI (0.10, 2.19)) in patients assigned to the evening dosing regimen drug therapy group. Patients showed no significant differences for all‐cause mortality and cardiovascular mortality. Conclusion This review shows that evening dosing regimen drug therapy could reverse non‐dipper BP patterns in hypertensive CKD patients.