Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of RCTs

source extracted confidence: high 2026-04-09
#humans #antihypertensive-agents #randomized-controlled-trials-as-topic #hypertension #blood-pressure

Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of RCTs

Kuang et al., 2025 | Am J Cardiovasc Drugs | Meta Analysis

Citation

Kuang Hongyu, Li Qiang, ... Du Huaan. Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of RCTs. Am J Cardiovasc Drugs. 2025-Sep;25(5):633-654. doi:10.1007/s40256-025-00731-2

Abstract

AIM: The aim of this study was to evaluate the efficacy of chronotherapy for patients with essential hypertension with a range of clinical characteristics. METHODS: We searched the PubMed, EMBASE, and Cochrane Library databases for randomized controlled trials of antihypertensive therapies in which patients were randomized to morning or evening administration. The primary outcomes of the included studies were ambulatory blood pressure (BP) parameters and patient characteristics, including age, body mass index, percentage of female participants, and drug ingestion, which were described in subgroup analyses. RESULTS: In total, 56 studies were included in the analyses. Meta-analyses and subgroup analyses revealed that specific populations of patients benefited more from bedtime dosing than from morning dosing in both 24-h or 48-h ambulatory systolic BP (SBP) and nighttime SBP, including (1) groups aged < 60 years, (2) those with body mass index ≥ 30 kg/m2, (3) studies with ≥ 50% female participants, and (4) patients receiving antihypertensive calcium channel blockers. However, when controversial data by Hermida et al. were omitted, the effects of BP controls were observed in patients with overweight, particularly obesity. Furthermore, calcium channel blockers contributed to an obvious reduction in nighttime SBP with chronotherapy. CONCLUSIONS: Chronotherapy for hypertension may not be completely ineffective, and the clinical program and timing of medication administration can be selected according to the patient's clinical characteristics. Registration PROSPERO identifier number CRD42021292795.

Key Findings

In total, 56 studies were included in the analyses. Meta-analyses and subgroup analyses revealed that specific populations of patients benefited more from bedtime dosing than from morning dosing in both 24-h or 48-h ambulatory systolic BP (SBP) and nighttime SBP, including (1) groups aged < 60 years, (2) those with body mass index ≥ 30 kg/m2, (3) studies with ≥ 50% female participants, and (4) patients receiving antihypertensive calcium channel blockers. However, when controversial data by Hermi

Outcomes Measured

  • blood pressure
  • systolic blood pressure

Population

Field Value
Population essential hypertension with a
Sample Size 56
Age Range See abstract
Condition hypertension

MeSH Terms

  • Humans
  • Antihypertensive Agents
  • Randomized Controlled Trials as Topic
  • Hypertension
  • Blood Pressure
  • Drug Chronotherapy
  • Female
  • Essential Hypertension
  • Chronotherapy
  • Middle Aged
  • Calcium Channel Blockers
  • Body Mass Index

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09