Mortality in hypertensive patients with coronary heart disease depends on chronopharmacotherapy and dipping status

Abstract

Background: The goal of our study was to assess the influence of hypertension chronopharmacotherapy on diurnal blood pressure (BP) profile and mortality.

Methods: Subjects with established coronary heart disease (CHD) (n = 1345, mean age 63.2 ± 9.2 years) were included.

Results: Non-dipping status was related to a lack of nighttime hypertensive drug administration (OR 3.87, 95% CI 3.00-4.98). In a Cox proportional hazards regression model, non-dipping status (HR 1.17, 95% CI 1.02-1.47) and non-nighttime antihypertensive drug administration (HR 1.13, 95% CI 1.01-1.45) were predictors of all-cause mortality.

Conclusions: The non-dipping profile of CHD patients and increased mortality were related to a lack of antihypertensive drug administration at bedtime.

Keywords: Blood pressure profile; Chronopharmacotherapy; Coronary heart disease; Hypertension; Non-dippers.