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- N P Riksen and J Deinum.
- UMC St Radboud, afd. Algemeen Interne Geneeskunde, Nijmegen.
- Ned Tijdschr Geneeskd. 2013 Jan 1; 157 (34): A6022.
AbstractIn a reasonably large proportion of patients who take antihypertensive drugs (10-30%), hypertension appears to be therapy resistant; even the use of three antihypertensives does not lower the blood pressure sufficiently. The average nocturnal blood pressure is a better predictor of cardiovascular events than blood pressure measured during the day. Antihypertensives have a stronger effect on nocturnal blood pressure when taken in the evening rather than in the morning. The exact mechanism of this has not yet been unravelled, but randomised, non-blinded studies suggest that this so-called chronotherapy does indeed lower cardiovascular risk in certain groups. The authors regard this as a promising strategy for patients with therapy-resistant hypertension in whom a nocturnal blood pressure dip does not occur.
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