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Bedtime Dosing Significantly Lowers Morning Blood Pressure In Hypertensives
A DGReview of :"Therapeutic effects of evening administration of guanabenz and clonidine on morning hypertension: evaluation using home-based blood pressure measurements"
Journal of Hypertension
04/09/2003
By David Loshak
Evening administration of the central alpha(2)-agonists guanabenz and clonidine effectively suppresses elevated blood pressure in the morning in hypertensive patients.
Researchers in Sendai, Japan, assigned 133 patients with morning hypertension to receive once-daily evening administration of guanabenz or clonidine for four weeks.
Guanabenz 2.0 mg/day was given at bedtime to 80 patients and 4.0 mg/day to two patients. Clonidine 75 micrograms/day was given, also at bedtime, to 40 patients and 150 micrograms/day to 10 patients.
The blood pressure-lowering effects of the two drugs in the morning and evening were evaluated by patients' self-monitoring of blood pressure in their own homes.
The patients were then sub-divided into different groups according to their evening blood pressure. The effects of guanabenz and clonidine on this were evaluated further for each group.
In addition, as a substitute for the trough/peak ratio, the researchers assessed the evening/morning ratio to assess the duration of action of the two drugs.
The researchers found that evening dosing with guanabenz and clonidine lowered morning blood pressure significantly. Both drugs reduced evening blood pressure in the sub-group of patients whose evening blood pressure was high but not in those in whom it was normal.
Individual evening/morning ratios for guanabenz, but not for clonidine, were significantly greater in patients whose evening blood pressure was high than in those in whom it was normal.
Early during treatment, guanabenz produced a higher diastolic evening/morning ratio than clonidine in patients with a high evening diastolic blood pressure.
Journal of Hypertension 2003;21:4:805-811.
"Therapeutic effects of evening administration of guanabenz and clonidine on morning hypertension: evaluation using home-based blood pressure measurements"
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