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Evening versus morning dosing regimen drug therapy for chronic kidney disease patients with hypertension in blood pressure patterns: a systematic review and meta-analysis

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机构: [1]Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University [2]Department of Nephrology, The Second People’sHospital of Shanxi Province, Shanxi [3]Department of Laboratory Medicine,The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou [4]Department of Endocrinology, The Affiliated Tianyou Hospital, Wuhan University of Science and Technology,Wuhan, China [5]Operation Room, The Third Affiliated Hospital of Sun Yat-sen University
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关键词: blood pressure pattern chronic kidney disease evening dosing regimen drug therapy hypertension meta-analysis

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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, ASNONLINE, 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.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2015]版:
Q2 MEDICINE, GENERAL & INTERNAL
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Q2 MEDICINE, GENERAL & INTERNAL

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第一作者机构: [1]Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University [2]Department of Nephrology, The Second People’sHospital of Shanxi Province, Shanxi
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通讯机构: [1]Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University [*1]Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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