Effectiveness of Night Administration of Low Dose Aspirin in Hypertensive Patients

Effectiveness of the Timing of the Administration of Aspirin in Hypertensive Patients Treated With Low Doses of Acetyl Salicylic Acid for Secondary Prevention - TAHPS

The goal is to investigate in patients with high blood pressure, BP, namely, those with systolic blood pressure and diastolic blood pressure, SBP/DBP higher than or equal to 140/90 mmHg, and high cardiovascular risk, under treatment with low-dose acetylsalicylic acid, ASA, whether changing the time they take the drug (same dose) to bedtime (from taking it at some point during the active part of the day) produces a drop in their blood pressure (mean systolic and diastolic over 24 hours) of at least 2.5 mm Hg; and also whether among non-dippers, under secondary treatment with low-dose ASA, there is be a greater decrease in their night BP when the drug is taken in the evening.

Inclusion Criteria:

• Hypertensive patients (≥140/90)
• Patients from 18 to 80 years old
• Patients are currently taking low doses of ASA during the day, for secondary prevention of cardiovascular events
• Patients have been stable for at least one month with their current antihypertensive and antiplatelet therapy.

Exclusion Criteria:

• Severe and/or terminal illness
• Moderate/severe congestive heart failure (CHF), New York Heart Association, NYHA stage ≥ III
• Moderate/severe chronic renal failure glomerular filtration rate <45ml/min.
• Physical or mental illness that prevents the patient´s collaboration
• Being a heavy drinker, consuming more than 280 g of alcohol per week in the case of men or 170 g for women31
• Concomitant treatment with other antiplatelets or anticoagulants
• Taking nonsteroidal antiinflammatory drugs, NSAIDs, on a regular basis
• Treatment with ASA at doses outside those established in the inclusion criteria (above)
• ASA already being taken in the evening
• Being a shift worker or having a very intensive work schedule
• Hospital admission during the clinical trial
• Changes being made in the antihypertensive and antiplatelet therapy taken by the patient during the seven months of the trial
• Patients with unstable treatment or clinical condition requiring frequent adjustments thereof.
• Compliance with less than 90% of the doses, both those for daytime and those for evening administration