Chronopharmacology of antihypertensives

Abstract

Pharmacological treatments of hypertension are associated with a reduction in cardiovascular risk. The blood pressure of both normotensive and hypertensive patients has a particular pattern associated to the biological clock set according to a circadian rhythm. One of the aims of this study was to test the long acting anti-hypertensive medications, atenolol and perindopril for their chronopharmacological properties in their effect on systolic and diastolic blood pressure levels over a period of 24 hours when administered in the morning or evening. Other aims were to compare blood pressure control in patients on atenolol and perindopril with control and normotensive patients and to obtain hourly systolic and diastolic blood pressure values using the ambulatory blood pressure monitor. An ambulatory blood pressure monitor was applied to the recruited patients for 24 hours and results analysed. Atenolol provides better blood pressure control during the early morning following a morning dose, whilst it results in an elevated blood pressure during the early morning when administered in the evening. Evening administered perindopril did not result in optimum blood pressure control throughout the 24h whilst morning administration resulted in an elevated early morning peak during the critical early morning period.