Caixia Wang1, Xilian Qiu2, Linsheng Lv3, Jianhua Huang4, Shaomin Li1, Tanqi Lou5, Xun Liu6. 1. Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. 2. Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 3. Operation Room, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 4. Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 5. Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. lou.tq@163.com. 6. Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. naturestyle@163.com.
Abstract
PURPOSE: To investigate the effects of chronotherapy on blood pressure in patients with chronic kidney disease (CKD). METHODS: We searched PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference articles of published papers without language restriction, for randomized and non-randomized trials that assessed the effect of chronotherapy versus morning dosing regimen drug therapy for CKD patients with hypertension. Meta-analysis was done with random-effect models. RESULTS: After application of inclusion/exclusion criteria, three randomized controlled trials including 3380 patients were analyzed. Compared with morning dosing regimen drug therapy, chronotherapy was associated with a significant decrease of 3.55% in sleep-time relative decline of systolic blood pressure (SBP) (mean difference [MD], 95% CI, [0.22, 6.88]). In the chronotherapy group, we noted a significant decrease in nocturnal SBP (MD -3.79 mmHg, 95% CI, [-7.18, -0.41]) and nocturnal diastolic blood pressure (MD -1.55 mmHg, 95% CI. [- 2.28, -0.82]), but there was a small increase in awake SBP by 1.19 mmHg (MD, 95% CI, [0.06, 2.31]). No significant difference was noted in all-cause mortality and cardiovascular mortality. CONCLUSION: This meta-analysis suggests that chronotherapy could reduce nocturnal BP in hypertensive CKD patients.
PURPOSE: To investigate the effects of chronotherapy on blood pressure in patients with chronic kidney disease (CKD). METHODS: We searched PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference articles of published papers without language restriction, for randomized and non-randomized trials that assessed the effect of chronotherapy versus morning dosing regimen drug therapy for CKDpatients with hypertension. Meta-analysis was done with random-effect models. RESULTS: After application of inclusion/exclusion criteria, three randomized controlled trials including 3380 patients were analyzed. Compared with morning dosing regimen drug therapy, chronotherapy was associated with a significant decrease of 3.55% in sleep-time relative decline of systolic blood pressure (SBP) (mean difference [MD], 95% CI, [0.22, 6.88]). In the chronotherapy group, we noted a significant decrease in nocturnal SBP (MD -3.79 mmHg, 95% CI, [-7.18, -0.41]) and nocturnal diastolic blood pressure (MD -1.55 mmHg, 95% CI. [- 2.28, -0.82]), but there was a small increase in awake SBP by 1.19 mmHg (MD, 95% CI, [0.06, 2.31]). No significant difference was noted in all-cause mortality and cardiovascular mortality. CONCLUSION: This meta-analysis suggests that chronotherapy could reduce nocturnal BP in hypertensiveCKDpatients.
Authors: Michael H Smolensky; Ramón C Hermida; Diana E Ayala; Ruana Tiseo; Francesco Portaluppi Journal: Blood Press Monit Date: 2010-08 Impact factor: 1.444
Authors: J A Staessen; L Thijs; R Fagard; E T O'Brien; D Clement; P W de Leeuw; G Mancia; C Nachev; P Palatini; G Parati; J Tuomilehto; J Webster Journal: JAMA Date: 1999-08-11 Impact factor: 56.272