Yadav Jasmine, Khan Naim, Das RIna, Mehta Dinesh Kumar
M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, HR, India.
Curr Hypertens Rev. 2025;21(1):15-30. doi: 10.2174/0115734021332079241226115916.
Hypertension, a prevalent global health issue, poses significant risks for morbidity and mortality. The interplay between hypertension and comorbidities like diabetes and chronic kidney disease (CKD) underscores the urgency for effective management strategies. Chronotherapy, aligning medication administration with circadian rhythms, emerges as a promising approach to optimize treatment outcomes. The objective of this study is to assess the safety and efficacy of the use of ACEIs and ARBs in the chronotherapeutic treatment of hypertension. We aim to clarify the influence of circadian blood pressure patterns on the efficacy of medications and investigate the potential of chronotherapy in the management of hypertension by conducting a thorough examination of the existing literature. A literature search spanning from January 1980 to 2023 was conducted using PubMed, Scopus and Google Scholar databases. Search terms included ACE inhibitors, ARBs, chronotherapy, hypertension, and circadian rhythm of blood pressure. Studies investigating the effects of chronotherapy with ACEIs and ARBs in hypertensive patients were analyzed. Chronotherapy offers a personalized approach to hypertension management, leveraging the dynamic nature of circadian rhythms. By administering ACEIs or ARBs at night, the risk of morning blood pressure surges, associated with adverse cardiovascular events, can be mitigated. However, the optimal timing and combination of medications remain areas of ongoing research. Our review highlights the potential of chronotherapy with ACEIs and ARBs as a promising avenue for hypertension treatment. Further research is warranted to elucidate the mechanisms underlying circadian blood pressure regulation and optimize chronotherapeutic strategies. This comprehensive evaluation underscores the need for personalized treatment approaches tailored to individual circadian rhythms for improved hypertension management and reduced cardiovascular risk.
高血压是一个普遍存在的全球健康问题，对发病率和死亡率构成重大风险。高血压与糖尿病和慢性肾脏病（CKD）等合并症之间的相互作用凸显了有效管理策略的紧迫性。时间治疗法，即将药物给药与昼夜节律相匹配，成为一种有前景的优化治疗效果的方法。本研究的目的是评估血管紧张素转换酶抑制剂（ACEIs）和血管紧张素Ⅱ受体阻滞剂（ARBs）在高血压时间治疗中的安全性和有效性。我们旨在通过对现有文献进行全面审查，阐明昼夜血压模式对药物疗效的影响，并研究时间治疗法在高血压管理中的潜力。使用PubMed、Scopus和谷歌学术数据库进行了从1980年1月到2023年的文献检索。检索词包括ACE抑制剂、ARBs、时间治疗法、高血压和血压昼夜节律。分析了研究ACEIs和ARBs时间治疗对高血压患者影响的研究。时间治疗法为高血压管理提供了一种个性化方法，利用了昼夜节律的动态特性。通过在夜间服用ACEIs或ARBs，可以降低与不良心血管事件相关的早晨血压飙升风险。然而，药物的最佳给药时间和联合用药仍在研究之中。我们的综述强调了ACEIs和ARBs时间治疗法作为高血压治疗有前景途径的潜力。有必要进一步研究以阐明昼夜血压调节的潜在机制并优化时间治疗策略。这种全面评估强调了需要根据个体昼夜节律制定个性化治疗方法，以改善高血压管理并降低心血管风险。
