title: [Differences in the reduction of blood pressure according to drug administration at activity hours or rest hours].
abstract: OBJECTIVE
  In this study, 123 recordings of blood pressure (BP) obtained by ambulatory BP monitoring were analyzed. These recordings were measured in 2011 in patients from a Spanish tertiary university hospital. All participating patients were treated with 2, 3 or 4 anti-hypertensive drugs. The main aim of this study was to determine differences in BP control, if any, depending on the medication schedule. Thus, BP levels were studied at 3 periods of the day: activity hours, rest hours and 24h.
  
  
  METHODS
  We compared subjects taking all anti-hypertensive agents during the day (n=70, group 1) with those taking at least one at night (n=53, group 2).
  
  
  RESULTS
  Significant differences were found on diastolic BP, where group 2 patients had lower levels at activity, 24h periods and sleep-time. Even if it was not statistically significant, lower levels of systolic BP from group 2 were also observed at activity and 24h periods as well as lower levels of systolic, diastolic and mean BP at rest hours periods. There were also significant group differences in relation to the number of prescribed agents (with the mean being higher for group 2) and the type of agent (beta-blockers and calcium antagonists were more prevalent in group 2). Nevertheless, the multivariate regression analysis done taking into account these variables did not change the observed statistical significance.
  
  
  CONCLUSIONS
  The administration of anti-hypertensive drugs at night could be associated with lower BP levels.
authors.affiliation: Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona, España. Electronic address: paola_ponte@yahoo.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Helena Ponte Márquez
authors.affiliation: Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Maria
authors.initials: M
authors.lastname: José Solé
authors.affiliation: Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Arroyo
authors.affiliation: Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Laia
authors.initials: L
authors.lastname: Matas
authors.affiliation: Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Benet
authors.affiliation: Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Àlex
authors.initials: À
authors.lastname: Roca-Cusachs
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D055870:Drug Chronotherapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012146:Rest; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D014851:Wakefulness
chemical_list: D000959:Antihypertensive Agents
keywords: Ambulatory blood pressure monitoring; Circadian profile; Eficacia del Tratamiento; Monitorización ambulatoria de la presión arterial; Patrón circadiano; Treatment efficacy