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2000
Volume 21, Issue 1
  • ISSN: 1573-4021
  • E-ISSN: 1875-6506

Abstract

Hypertension, a prevalent global health issue, poses significant risks for morbidity and mortality. The interplay between hypertension and comorbidities like diabetes and chronic kidney disease (CKD) underscores the urgency for effective management strategies. Chronotherapy, aligning medication administration with circadian rhythms, emerges as a promising approach to optimize treatment outcomes.

The objective of this study is to assess the safety and efficacy of the use of ACEIs and ARBs in the chronotherapeutic treatment of hypertension. We aim to clarify the influence of circadian blood pressure patterns on the efficacy of medications and investigate the potential of chronotherapy in the management of hypertension by conducting a thorough examination of the existing literature.

A literature search spanning from January 1980 to 2023 was conducted using PubMed, Scopus and Google Scholar databases. Search terms included ACE inhibitors, ARBs, chronotherapy, hypertension, and circadian rhythm of blood pressure. Studies investigating the effects of chronotherapy with ACEIs and ARBs in hypertensive patients were analyzed.

Chronotherapy offers a personalized approach to hypertension management, leveraging the dynamic nature of circadian rhythms. By administering ACEIs or ARBs at night, the risk of morning blood pressure surges, associated with adverse cardiovascular events, can be mitigated. However, the optimal timing and combination of medications remain areas of ongoing research.

Our review highlights the potential of chronotherapy with ACEIs and ARBs as a promising avenue for hypertension treatment. Further research is warranted to elucidate the mechanisms underlying circadian blood pressure regulation and optimize chronotherapeutic strategies. This comprehensive evaluation underscores the need for personalized treatment approaches tailored to individual circadian rhythms for improved hypertension management and reduced cardiovascular risk.

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2025-09-06

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References

  1. HermidaR.C. AyalaD.E. PortaluppiF. Circadian variation of blood pressure: The basis for the chronotherapy of hypertension.Adv. Drug Deliv. Rev.2007599-1090492210.1016/j.addr.2006.08.00317659807
     [Google Scholar]
  2. ShahS.P. BorahG.P. BansalA. BhattiK. DasR. MehtaD.K. Impact of anti-hypertensive medication on physical and psychological Health Related Quality of Life (HRQOL) in hypertensive patients.J. Young Pharm.202315237237910.5530/jyp.2023.15.50
     [Google Scholar]
  3. SainiM. RanaM. BhattiK. DasR. Kumar MehtaD. Understanding health related quality of life in hypertensive patients: Interrogating effect of psychological and environmental factors.J. Young Pharm.202214110010510.5530/jyp.2022.14.19
     [Google Scholar]
  4. SmolenskyM.H. HermidaR.C. AyalaD.E. TiseoR. PortaluppiF. Administration–time-dependent effects of blood pressure-lowering medications: Basis for the chronotherapy of hypertension.Blood Press. Monit.201015417318010.1097/MBP.0b013e32833c730820571367
     [Google Scholar]
  5. UshijimaK. NakashimaH. ShigaT. HaradaK. IshikawaS. IokaT. AndoH. FujimuraA. Different chronotherapeutic effects of valsartan and olmesartan in non-dipper hypertensive patients during valsartan treatment at morning.J. Pharmacol. Sci.20151271626810.1016/j.jphs.2014.09.00425704020
     [Google Scholar]
  6. De GiorgiA. MenegattiAM. FabbianF. PortaluppiF. ManfrediniR. Circadian rhythms and medical diseases: Does it matter when drugs are taken?Eur. J. Intern. Med.201324869870610.1016/j.ejim.2013.03.01923611529
     [Google Scholar]
  7. DasR. MehtaD.K. Considering circadian pattern of blood pressure in treatment of hypertension via chronotherapy: A conducive or a maladroit approach.Curr. Drug Targets201920121244125410.2174/138945012066619052711452931131750
     [Google Scholar]
  8. DasR. MehtaD.K. ShahS.P. BorahG.P. Swotting effective hypertension therapy: Ramipril versus telmisartan.J. Med. Pharm. Allied Sci.20231215532553910.55522/jmpas.V12I1.4280
     [Google Scholar]
  9. KramerS. P.M. Dosing Outcomes of ACE Inhibitors or Angiotensin II Receptor Blockers in Hypertension Versus P.M. Dosing in Hypertension with Comorbidities.Physician Assistant Scholarly Project Papers2021105129
     [Google Scholar]
  10. HermidaR.C. AyalaD.E. SmolenskyM.H. FernándezJ.R. MojónA. PortaluppiF. Chronotherapy with conventional blood pressure medications improves management of hypertension and reduces cardiovascular and stroke risks.Hypertens. Res.201639527729210.1038/hr.2015.14226657008
     [Google Scholar]
  11. CostelloH.M. GumzM.L. Circadian rhythm, clock genes, and hypertension: Recent advances in hypertension.Hypertension20217851185119610.1161/HYPERTENSIONAHA.121.1451934601963
     [Google Scholar]
  12. Millar-CraigM. BishopC. RafteryE.B. Circadian variation of blood-pressure.Lancet1978311806879579710.1016/S0140‑6736(78)92998‑785815
     [Google Scholar]
  13. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Cardiovascular risk of essential hypertension: Influence of class, number, and treatment-time regimen of hypertension medications.Chronobiol. Int.2013301-231532710.3109/07420528.2012.70153423181712
     [Google Scholar]
  14. PickeringT.G. JamesG.D. Determinants and consequences of the diurnal rhythm of blood pressure.Am. J. Hypertens.199366 Pt 2166S169S10.1093/ajh/6.6.166S8347311
     [Google Scholar]
  15. JamesG.D. PickeringT.G. The influence of behavioral factors on the daily variation of blood pressure.Am. J. Hypertens.199366_Pt_2170S173S10.1093/ajh/6.6.170S8347312
     [Google Scholar]
  16. SicaD.A. What are the influences of salt, potassium, the sympathetic nervous system, and the renin-angiotensin system on the circadian variation in blood pressure?Blood Press. Monit.19994Suppl. 2S9S1610822417
     [Google Scholar]
  17. MansoorG.A. WhiteW.B. McCabeE.J. GiaccoS. The relationship of electronically monitored physical activity to blood pressure, heart rate, and the circadian blood pressure profile.Am. J. Hypertens.200013326226710.1016/S0895‑7061(99)00147‑810777030
     [Google Scholar]
  18. LusardiP. ZoppiA. PretiP. PesceR.M. PiazzaE. FogariR. Effects of insufficient sleep on blood pressure in hypertensive patients A 24-h study.Am. J. Hypertens.1999121636810.1016/S0895‑7061(98)00200‑310075386
     [Google Scholar]
  19. MiyajimaE. YamamotoH. EmotoT. KawaharaK. Relationship between nocturnal blood pressure and environmental temperature in patients with hypertension.Intern. Med.2015541012011207
     [Google Scholar]
  20. LuiD.T. HallA.J. AguilarD. YeeB.J. GrunsteinR.R. Impact of bright light on cardiovascular circadian rhythms in hypertensive and normotensive individuals.Hypertens. Res.201336982983523676848
     [Google Scholar]
  21. Martínez-GarcíaM.A. CapoteF. Campos-RodríguezF. LloberesP. Díaz de AtauriM.J. SomozaM. MasaJ.F. GonzálezM. SacristánL. BarbéF. Durán-CantollaJ. AizpuruF. MañasE. BarreiroB. MosteiroM. CebriánJ.J. de la PeñaM. García-RíoF. MaimóA. ZapaterJ. HernándezC. Grau SanMartiN. MontserratJ.M. Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial.JAMA2013310222407241510.1001/jama.2013.28125024327037
     [Google Scholar]
  22. RuidavetsJ.B. BongardV. SimonC. DallongevilleJ. DucimetièreP. ArveilerD. FerrièresJ. Independent contribution of alcohol consumption to blood pressure and its relation with a family history of hypertension: The ECTIM study.J. Hypertens.201028918791885
     [Google Scholar]
  23. SteptoeA. CropleyM. GriffithJ. JoekesK. The influence of work stress and driving duration on cardiovascular and cortisol variables.J. Occup. Health Psychol.199942143153
     [Google Scholar]
  24. FranklinS.S. GustinW.IV WongN.D. LarsonM.G. WeberM.A. KannelW.B. LevyD. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study.Circulation199796130831510.1161/01.CIR.96.1.3089236450
     [Google Scholar]
  25. LohM. KohK.H. KhinL.W. ChiaK.S. ChewC.H. Blood pressure circadian rhythm genetics and cardiovascular disease: A systematic review.J. Hum. Hypertens.20163026170
     [Google Scholar]
  26. MatsuiT. IshikawaT. OhtaT. ObaraK. IshiiK. HirataK. MuroharaT. Different impacts of menstrual cycle on ambulatory blood pressure according to age.Hypertens. Res.2011342269274
     [Google Scholar]
  27. PalatiniP. PenzoM. CanaliC. PessinaA.C. RossiG.P. Dipping status may be determined by the level of obesity in essential hypertensive patients.Am. J. Hypertens.199811113051313
     [Google Scholar]
  28. PedrosaR.P. DragerL.F. GonzagaC.C. SousaM.G. de PaulaL.K.G. AmaroA.C.S. AmodeoC. BortolottoL.A. KriegerE.M. BradleyT.D. Lorenzi-FilhoG. Obstructive sleep apnea: The most common secondary cause of hypertension associated with resistant hypertension.Hypertension201158581181710.1161/HYPERTENSIONAHA.111.17978821968750
     [Google Scholar]
  29. CrespoJ.J. PiñeiroL. OteroA. CastiñeiraC. RíosM.T. RegueiroA. MojónA. LorenzoS. AyalaD.E. HermidaR.C. Hygia Project Investigators Administration-time-dependent effects of hypertension treatment on ambulatory blood pressure in patients with chronic kidney disease.Chronobiol. Int.2013301-215917510.3109/07420528.2012.70145923098134
     [Google Scholar]
  30. SleightP. The HOPE study (Heart Outcomes Prevention Evaluation).J. Renin Angiotensin Aldosterone Syst.200011182010.3317/jraas.2000.00211967789
     [Google Scholar]
  31. StaessenJ.A. FagardR. ThijsL. CelisH. ArabidzeG.G. BirkenhägerW.H. BulpittC.J. de LeeuwP.W. DolleryC.T. FletcherA.E. ForetteF. LeonettiG. NachevC. O'BrienE.T. RosenfeldJ. RodicioJ.L. TuomilehtoJ. ZanchettiA. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators.Lancet1997350908075776410.1016/s0140‑6736(97)05381‑69297994
     [Google Scholar]
  32. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Influence of circadian time of hypertension treatment on cardiovascular risk: Results of the MAPEC study.Chronobiol. Int.20102781629165110.3109/07420528.2010.51023020854139
     [Google Scholar]
  33. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Influence of time of day of blood pressure-lowering treatment on cardiovascular risk in hypertensive patients with type 2 diabetes.Diabetes Care20113461270127610.2337/dc11‑029721617110
     [Google Scholar]
  34. HermidaR.C. AyalaD.E. CalvoC. PortaluppiF. SmolenskyM.H. Chronotherapy of hypertension: Administration-time-dependent effects of treatment on the circadian pattern of blood pressure.Adv. Drug Deliv. Rev.2007599-1092393910.1016/j.addr.2006.09.02117659803
     [Google Scholar]
  35. VernonG. The chronotherapy of hypertension: Or the benefit of taking blood pressure tablets at bedtime.Br. J. Gen. Pract.20176765717110.3399/bjgp17X69026928360059
     [Google Scholar]
  36. DickerD. AtarS. MeisnerR. IzhakianS. BirkhanO. BorerA. Time-dependent effects of angiotensin receptor blockers on renal function and albuminuria in hypertensive patients with type 2 diabetes mellitus.J. Clin. Hypertens. (Greenwich)2016181010191025
     [Google Scholar]
  37. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Bedtime ingestion of hypertension medications reduces the risk of new-onset type 2 diabetes: A randomised controlled trial.Diabetologia201659225526510.1007/s00125‑015‑3749‑726399404
     [Google Scholar]
  38. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Bedtime dosing of antihypertensive medications reduces cardiovascular risk in CKD.J. Am. Soc. Nephrol.201122122313232110.1681/ASN.201104036122025630
     [Google Scholar]
  39. SakaiY. SuzukiA. MugishimaK. SumiY. OtsukaY. OtsukaT. OhnoD. MurasawaT. TsuruokaS. Comparison of once daily versus twice daily olmesartan in patients with chronic kidney disease.Int. J. Nephrol. Renovasc. Dis.20136622322710.2147/IJNRD.S5290524143121
     [Google Scholar]
  40. WangC. ZhangJ. LiuX. LiC.C. YeZ.C. PengH. ChenZ. LouT. Effect of valsartan with bedtime dosing on chronic kidney disease patients with nondipping blood pressure pattern.J. Clin. Hypertens. (Greenwich)2013151485410.1111/jch.1202123282124
     [Google Scholar]
  41. SarafidisP.A. KhoslaN. BakrisG.L. Antihypertensive therapy in the presence of proteinuria.Am. J. Kidney Dis.2007491122610.1053/j.ajkd.2006.10.01417185142
     [Google Scholar]
  42. KunzR. FriedrichC. WolbersM. MannJ.F.E. ReiboldJ.P. Meta-analysis: Effect of monotherapy and combination therapy with inhibitors of the renin angiotensin system on proteinuria in renal disease.Ann. Intern. Med.20081481304810.7326/0003‑4819‑148‑1‑200801010‑0019017984482
     [Google Scholar]
  43. ZengZ. YangY. ZhangY. WuX. ChenW. GuD. Effect of antihypertensive medications on sleep status in hypertensive patients.Sleep Biol Rhythms202220447348010.1007/s41105‑022‑00391‑838468617
     [Google Scholar]
  44. BurnierM. EganB.M. Adherence in hypertension.Circ. Res.201912471124114010.1161/CIRCRESAHA.118.31322030920917
     [Google Scholar]
  45. MoriH. YamamotoH. UkaiH. YuasaS. NakajimaK. MikawaT. NiizumaM. HiraoK. UmemuraS. COMPATIBLE Study Group Comparison of effects of angiotensin II receptor blocker on morning home blood pressure and cardiorenal protection between morning administration and evening administration in hypertensive patients: the COMPATIBLE study.Hypertens. Res.201336320220710.1038/hr.2012.14223013888
     [Google Scholar]
  46. HermidaR.C. AyalaD.E. ChayanL. MojonA. FernandezJR. Administration-time-dependent effects of olmesartan on the ambulatory blood pressure of essential hypertension patients.Chronobiol Int20092616179
     [Google Scholar]
  47. HermidaR.C. AyalaD.E. FernándezJ.R. CalvoC. Comparison of the efficacy of morning versus evening administration of telmisartan in essential hypertension.Hypertension200750471572210.1161/HYPERTENSIONAHA.107.09423517635851
     [Google Scholar]
  48. CalvoC. HermidaA. LopezJ.E. PenaM. CalvoG. RomeroM.L. MartinezV. PascualA. RiveiroA. PoseA. 545 Administration of aliskiren and valsartan and its chronotherapeutic effects on diabetic nephropathy.J. Hypertens.2012305Suppl. 1e160e7110.1097/01.hjh.0000420818.81645.e6
     [Google Scholar]
  49. PovedanoST. De La VillaBG. 24-hour and nighttime blood pressures in type 2 diabetic hypertensive patients following morning or evening administration of olmesartan.J. Clin. Hypertens. (Greenwich)200911842643110.1111/j.1751‑7176.2009.00152.x19695030
     [Google Scholar]
  50. HermidaR.C. CrespoJ.J. Domínguez-SardiñaM. OteroA. MoyáA. RíosM.T. SineiroE. CastiñeiraM.C. CallejasP.A. PousaL. SalgadoJ.L. DuránC. SánchezJ.J FernándezJ.R. MojónA. AyalaD.E. Bedtime hypertension treatment improves cardiovascular risk reduction: The Hygia Chronotherapy Trial.Eur Heart J.202041484565457610.1093/eurheartj/ehz75431641769
     [Google Scholar]
  51. HermidaR.C. AyalaD.E. Chronotherapy with the angiotensin-converting enzyme inhibitor ramipril in essential hypertension: Improved blood pressure control with bedtime dosing.Hypertension2009541404610.1161/HYPERTENSIONAHA.109.13020319433778
     [Google Scholar]
  52. DjavadkhaniY. YeeB. GrunsteinR. WongK. CistulliP.A. ArimaH. PhillipsC.L. Evening versus morning administration of an ace-inhibitor and its effects on 24-hour blood pressure control in patients with obstructive sleep apnoea and hypertension.Am. J. Respir. Crit. Care Med.20161932135
     [Google Scholar]
  53. BalanH. PopescuE. AngelescuG. Time-dependent effects of zofenopril administration on ambulatory blood pressure value.Rom. J. Intern. Med.2010491758422026256
     [Google Scholar]
  54. HermidaR.C. AyalaD.E. FontaoM.J. MojónA. AlonsoI. FernándezJ.R. Administration-time-dependent effects of spirapril on ambulatory blood pressure in uncomplicated essential hypertension.Chronobiol. Int.201027356057410.3109/07420528.2010.48541120524801
     [Google Scholar]
  55. GorbunovV.M. FedorovaE.J. DeevA.D. PlatonovaE.V. IsaikinaO.J. Effect of morning and evening ramipril taking on ambulatory blood pressure profile in patients with arterial hypertension.Ration. Pharmacother. Cardiol.200951283210.20996/1819‑6446‑2009‑5‑1‑28‑32
     [Google Scholar]
  56. HermidaR.C. AyalaD.E. MojónA. FernándezJ.R. Risk of incident chronic kidney disease is better reduced by bedtime than upon-awakening ingestion of hypertension medications.Hypertens. Res.201841534235310.1038/s41440‑018‑0029‑129531290
     [Google Scholar]
  57. SethnaC.B. GrossmanL.G. DhanantwariP. GurusingheS. LaneyN. FrankR. MeyersK.E. Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti-hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial.Pediatr. Transplant.2020248e1385410.1111/petr.1385433026142
     [Google Scholar]
  58. HermidaR.C. AyalaD.E. MojónA. FontaoM.J. FernándezJ.R. Chronotherapy with valsartan/hydrochlorothiazide combination in essential hypertension: Improved sleep-time blood pressure control with bedtime dosing.Chronobiol. Int.201128760161010.3109/07420528.2011.58993521823969
     [Google Scholar]
  59. HermidaR.C. AyalaD.E. FontaoM.J. MojónA. FernándezJ.R. Chronotherapy with valsartan/amlodipine fixed combination: Improved blood pressure control of essential hypertension with bedtime dosing.Chronobiol. Int.20102761287130310.3109/07420528.2010.48916720653455
     [Google Scholar]
  60. HoshinoA. NakamuraT. MatsubaraH. The bedtime administration ameliorates blood pressure variability and reduces urinary albumin excretion in amlodipine-olmesartan combination therapy.Clin. Exp. Hypertens.201032741642210.3109/1064196100366794820828223
     [Google Scholar]
  61. HermidaR.C. FernándezJ.R. MojónA. Current evidence on the circadian-time-dependent effects of hypertension medications and their combinations in relation to findings of MAPEC and Hygia Chronotherapy Trial.Chronobiol. Int.202037575175810.1080/07420528.2020.177135632683989
     [Google Scholar]
  62. MengY. ZhangZ. LiangX. WuC. QiG. Effects of combination therapy with amlodipine and fosinopril administered at different times on blood pressure and circadian blood pressure pattern in patients with essential hypertension.Acta Cardiol.201065330931410.2143/AC.65.3.205034720666269
     [Google Scholar]
  63. FarahR. MakhoulN. ArrafZ. Khamisy-FarahR. Switching therapy to bedtime for uncontrolled hypertension with a nondipping pattern.Blood Press. Monit.201318422723110.1097/MBP.0b013e3283624aed23660686
     [Google Scholar]
  64. TiwariV. ChaudharyA. DasguptaS. DivyaveerS. SahuR. PalA. MondalR. ChakravartyK. MandalA. SircarD. PandeyR. Effect of chronotherapy of antihypertensives in chronic kidney disease: A randomized control trial.Indian J. Nephrol.202131191510.4103/ijn.IJN_322_1933994681
     [Google Scholar]
  65. MackenzieI.S. RogersA. PoulterN.R. WilliamsB. BrownM.J. WebbD.J. FordI. RorieD.A. GuthrieG. GrieveJ.W.K. PigazzaniF. RothwellP.M. YoungR. McConnachieA. StruthersA.D. LangC.C. MacDonaldT.M. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): A prospective, randomised, open-label, blinded-endpoint clinical trial.Lancet.2022400103611417142510.1016/S0140‑6736(22)01786‑X36240838
     [Google Scholar]
  66. HermidaR.C. AyalaD.E. FernándezJ.R. PortaluppiF. FabbianF. SmolenskyM.H. Circadian rhythms in blood pressure regulation and optimization of hypertension treatment with ACE inhibitor and ARB medications.Am. J. Hypertens.201124438339110.1038/ajh.2010.21720930708
     [Google Scholar]
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Understanding Efficacy of Using ACEIs and ARBs in Chronotherapeutic Treatment of Hypertension: Which Drug When?
Current Hypertension Reviews 21, 15 (2025); https://doi.org/10.2174/0115734021332079241226115916
/content/journals/chyr/10.2174/0115734021332079241226115916
/content/journals/chyr/10.2174/0115734021332079241226115916
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  • Article Type:     Review Article
Keyword(s): ACE inhibitors; ARBs; blood pressure; chronotherapy; circadian rhythm; Hypertension

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