Anti-hypertensive Medication Dosing Regimen in Effective Blood Pressure Control

Hellenic Anglo Research Into Morning Or Evening Antihypertensive Drug deliverY Trial

A randomised crossover trial of anti-hypertensive medication dosing regimen in effective blood pressure control.

To investigate whether there is a difference in 24 hour blood pressure (BP) control when antihypertensive medications are taken in the morning compared with the evening.

The identification of any significant difference could lead to more effective therapeutic management of arterial hypertension, which in turn would result in a reduced cardiovascular burden, lower costs and a better quality of life for hypertensive patients.

Inclusion Criteria:

• Caucasian patients aged 18-80 years;
• History of any grade of hypertension for at least 1 year, including at least 3 months of constant antihypertensive medication (consisting of ≥ 1 antihypertensive drugs, each administered in one dose daily), with reasonably controlled BP (≤150/90 mmHg and ≥ 115/75 mmHg on usual medication) based on previous clinic records, in the last 3 months.

Exclusion Criteria:

• BP levels > 150/90 mmHg or < 115/75 mmHg in the last 3 months.
• Postural hypotension, defined as symptoms resulting from a > 20 mm Hg drop of systolic BP or a > 10 mm Hg drop of diastolic BP or both between 1 and 3 min after standing from the sitting position.
• Known Extreme dippers at baseline (fall of mean night time SBP > 20% of mean day time SBP)
• Individuals with jobs which require night-time shift work.
• Pregnant women or those planning to become pregnant.