[Renin-angiotensin-aldosterone inhibitors for treatment of hypertension with abnormal circadian rhythm of blood pressure].

Circadian rhythm of blood pressure (BP) has recently been focused on because increase in nocturnal BP and morning BP surge have been shown to be risks for cardio-cerebrovascular diseases independent of 24-h BP level. The renin-angiotensin-aldosterone system (RAAS) is involved in BP circadian rhythm, and RAAS inhibitors therefore play an important role in the control of circadian rhythm of BP. Bedtime administration of RAAS inhibitors is more effective than morning administration for reducing nocturnal and morning BP levels in addition to converting the BP profile into a dipper pattern, which is known as chronotherapy. For reducing cardio-cerebro-vascular events, controlling abnormal circadian rhythm of BP in addition to 24-h BP using RAAS inhibitors with optimal time dosing should be considered.