• Ramón C Hermida, Ramón G Hermida-Ayala, and Michael Smolensky.
• Laboratorio de Bioingeniería y Cronobiología, Atlantic Research Center for Information and Communication Technologies (atlanTTic), Universidad de Vigo, Vigo, España; Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, Estados Unidos. Electronic address: rhermida@uvigo.es.
• Med Clin (Barc). 2020 Jun 26; 154 (12): 505-511.

AbstractNumerous prospective studies establish that elevated asleep blood pressure (BP) constitutes a significant cardiovascular disease (CVD) risk factor, irrespective of daytime office BP measurements or awake and 24h BP measurements. Moreover, except for a small number of studies with flawed methodology, multiple clinical trials of high consistency document significantly better BP-lowering efficacy of hypertension medication and their combinations when ingested at bedtime compared to upon awakening as is customary. Additionally, recent trials conclude bedtime hypertension chronotherapy markedly reduces CVD risk not only in the general population, but also in more vulnerable patients of advanced age, with kidney disease, diabetes, or resistant hypertension. Collectively, these results call for a new definition of true arterial hypertension and its proper diagnosis and management.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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