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Abstract: TH-PO215

Seize the Night: A Retrospective Cohort Analysis on the Timing of Antihypertensive Agents on Nocturnal Blood Pressure

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Michael, Sean, HCA Florida Oak Hill Hospital, Brooksville, Florida, United States
  • Huda, Hammad Ibrahim, HCA Florida Oak Hill Hospital, Brooksville, Florida, United States
  • Felix, Monicka, HCA Florida Oak Hill Hospital, Brooksville, Florida, United States

Hypertension is a long standing modifiable risk factor in cardiovascular disease. Blood pressure follows a circadian rhythm in response to hormonal and environmental factors. However, when this balance is disrupted it may lead to an elevated nighttime blood pressure which is a more significant predictor of cardiovascular mortality than daytime hypertension. This study aims to see if the timing of antihypertensive agents among those with hypertension and chronic kidney disease may reduce night-time blood pressure.


In this retrospective cohort analysis, 8814 patients (3975 female/4839 male, 65+/-9 years of age) with hypertension or chronic kidney disease who were admitted to HCA healthcare in 2021 and 2022 were categorized based on receiving blood pressure medication in the morning (n=2142), evening (n=176), or morning and evening (n=6209). In response, patients blood pressure at night time were measured to see if there was a normal blood pressure lowering pattern of 10-20% at night-time.


The results showed patients who had evening only blood pressure medicaiton were 1.842 times as a likely to have a night-time drop in blood pressure compared to patients whom had medication administered in the morning only(p=0.001, 95% CI [1.253-2.710] when all other variables were held constant.


Patients who administer an evening dose blood pressure medication are more likely to have an appropriate drop in night-time blood pressure. Clinicians can therefore consider switching antihypertensive agents to evening among patient with nocturnal hypertension. Furthermore, this study raises awareness regarding nocturnal hypertension, an often overlooked aspect in the treatment of hypertension.


  • Private Foundation Support