A Trial of 2 Strategies to Reduce Nocturnal Blood Pressure in Blacks With Chronic Kidney Disease
Open accessAbstract
The objective of our study was to determine the effects of 2 antihypertensive drug dose schedules (PM dose and add-on dose) on nocturnal blood pressure (BP) in comparison with usual therapy (AM dose) in blacks with hypertensive chronic kidney disease and controlled office BP. In a 3-period, crossover trial, former participants of the African American Study of Kidney Disease were assigned to receive the following 3 regimens, each lasting 6 weeks, presented in random order: AM dose (once-daily antihypertensive medications taken in the morning), PM dose (once-daily antihypertensives taken at bedtime), and add-on dose (once-daily antihypertensives taken in the morning and an additional antihypertensive medication before bedtime [diltiazem 60–120 mg, hydralazine 25 mg, or additional ramipril 5 mg]). Ambulatory BP monitoring was performed at the end of each period. The primary outcome was nocturnal systolic BP. Mean age of the study population (n=147) was 65.4 years, 64% were men, and mean estimated glomerular filtration rate was 44.9 mL/min per 1.73 m 2 . At the end of each period, mean (SE) nocturnal systolic BP was 125.6 (1.2) mm Hg in the AM dose, 123.9 (1.2) mm Hg in the PM dose, and 123.5 (1.2) mm Hg in the add-on dose. None of the pairwise differences in nocturnal, 24-hour, and daytime systolic BP was statistically significant. Among blacks with hypertensive chronic kidney disease, neither PM (bedtime) dosing of once-daily antihypertensive nor the addition of drugs taken at bedtime significantly reduced nocturnal BP compared with morning dosing of antihypertensive medications.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Although prior analyses of randomized clinical trials found a benefit to evening versus morning dosing of antihypertensive medications, these results have not been reproduced in subsequent trials.
“Although prior analyses of randomized clinical trials found a benefit to evening versus morning dosing of antihypertensive medications (81,82), these results have not been reproduced in subsequent trials.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [83]
The Discussion (page unavailable) reports earlier benefits from bedtime dosing, while this trial found no statistically significant reduction in nocturnal blood pressure with PM versus morning dosing. That supports a failure to reproduce a benefit in this trial, but the paper does not establish that subsequent trials generally failed to reproduce earlier results; its findings are limited to African Americans with hypertensive chronic kidney disease. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe benefit of evening versus morning antihypertensive dosing found in prior analyses has not been reproduced in subsequent trials.
“Although prior analyses of randomized clinical trials found a bene fi t to evening versus morning dosing of antihypertensive medications (74,75), these results have not been reproduced in subsequent trials.”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [76]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Prevalence of Chronic Kidney Disease in the United States
Coresh, J., Selvin, E., Stevens, L. A., Manzi, J., Kusek, J. W., Eggers, P., Van Lente, F., & Levey, A. S. (2007) · JAMA · doi:10.1001/jama.298.17.2038 · Cited by 4,895 · see citing works
Self-citationPickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., Jones, D. W., Kurtz, T., Sheps, S. G., & Roccella, E. J. (2005) · Circulation · doi:10.1161/01.cir.0000154900.76284.f6 · Cited by 3,985 · see citing works
Self-citationAmbulatory blood pressure. An independent predictor of prognosis in essential hypertension.
Verdecchia, P., Porcellati, C., Schillaci, G., Borgioni, C., Ciucci, A., Battistelli, M., Guerrieri, M., Gatteschi, C., Zampi, I., Santucci, A., et al. (1994) · Hypertension · doi:10.1161/01.hyp.24.6.793 · Cited by 1,671 · see citing works
Fagard, R. H., Celis, H., Thijs, L., Staessen, J. A., Clement, D. L., De Buyzere, M. L., & De Bacquer, D. A. (2008) · Hypertension · doi:10.1161/hypertensionaha.107.100727 · Cited by 742 · see citing works
Increase in Nocturnal Blood Pressure and Progression to Microalbuminuria in Type 1 Diabetes
Lurbe, E., Redón, J., Kesani, A., Pascual, J. M., Tacons, J., Álvarez, V., & BATLLE, D. C. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa013410 · Cited by 723 · see citing works
Hermida, R. C., Ayala, D. E., Mojón, A., & Fernández, J. R. (2010) · Chronobiology International · doi:10.3109/07420528.2010.510230 · Cited by 608 · see citing works
Fan, H. C., Li, Y., Thijs, L., Hansen, T. W., Boggia, J. G., Kikuya, M., Björklund‐Bodegârd, K., Richart, T., Ohkubo, T., Jeppesen, J., et al. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e32833b49fe · Cited by 393 · see citing works
Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease
Stenvinkel, P. (2010) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2010.02269.x · Cited by 331 · see citing works
Minutolo, R., Agarwal, R., Borrelli, S., Chiodini, P., Bellizzi, V., Nappi, F., Cianciaruso, B., Zamboli, P., Conte, G., Gabbai, F. B., et al. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.230 · Cited by 288 · see citing works
Self-citationPogue, V. A., Rahman, M., Lipkowitz, M. S., Toto, R. D., Miller, E. R., Faulkner, M. L., Rostand, S. G., Hiremath, L., Sika, M., Kendrick, C. A., et al. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.115154 · Cited by 282 · see citing works
Self-citationVerdecchia, P., Schillaci, G., Gatteschi, C., Zampi, I., Battistelli, M., Bartoccini, C., & Porcellati, C. (1993) · Circulation · doi:10.1161/01.cir.88.3.986 · Cited by 276 · see citing works
Bedtime Dosing of Antihypertensive Medications Reduces Cardiovascular Risk in CKD
Hermida, R. C., Ayala, D. E., Mojón, A., & Fernández, J. R. (2011) · Journal of the American Society of Nephrology · doi:10.1681/asn.2011040361 · Cited by 269 · see citing works
Agarwal, R., & Andersen, M. J. (2006) · Kidney International · doi:10.1038/sj.ki.5000247 · Cited by 253 · see citing works
Sturrock, N. D. C., George, E., Pound, N., Stevenson, J., Peck, G. M., & Sowter, H. (2000) · Diabetic Medicine · doi:10.1046/j.1464-5491.2000.00284.x · Cited by 171 · see citing works
Appel, L. J. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.8.832 · Cited by 166 · see citing works
Self-citationKario, K., Schwartz, J. E., & Pickering, T. G. (2000) · Hypertension · doi:10.1161/01.hyp.35.3.787 · Cited by 164 · see citing works
Emerging risk factors and markers of chronic kidney disease progression
Kronenberg, F. (2009) · Nature Reviews Nephrology · doi:10.1038/nrneph.2009.173 · Cited by 160 · see citing works
Hermida, R. C., Calvo, C., Ayala, D. E., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000084855.32823.da · Cited by 145 · see citing works
Minutolo, R., Gabbai, F. B., Borrelli, S., Scigliano, R., Trucillo, P., Baldanza, D., Laurino, S., Mascia, S., Conte, G., & Nicola, L. D. (2007) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2007.07.020 · Cited by 132 · see citing works
Self-citationKimura, G., Dohi, Y., & Fukuda, M. (2010) · Hypertension Research · doi:10.1038/hr.2010.47 · Cited by 127 · see citing works
The Impact of Obstructive Sleep Apnea on Chronic Kidney Disease
Adeseun, G. A., & Rosas, S. E. (2010) · Current Hypertension Reports · doi:10.1007/s11906-010-0135-1 · Cited by 110 · see citing works
The Rationale and Design of the AASK Cohort Study
Appel, L. J., Middleton, J. P., Miller, E. R., et al. (2003) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000070081.15137.c0 · Cited by 106 · see citing works
Self-citationWhite, W. B., Black, H. R., Weber, M. A., Elliott, W. J., Bryzinski, B. S., & Fakouhi, T. D. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00935-1 · Cited by 93 · see citing works
Hermida, R. C., Calvo, C., Ayala, D. E., Dominguez, M. J., Covelo, M., Fernández, J. R., Fontao, M. J., & López, J. E. (2004) · Chronobiology International · doi:10.1081/cbi-120037772 · Cited by 84 · see citing works
Peterson, G., Backer, T. L. M. D., Gabriel, A. P., Ilić, V., Vagaonescu, T. D., Appel, L. J., Contreras, G. N., Kendrick, C., Rostand, S. G., & Phillips, R. A. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.090613 · Cited by 55 · see citing works
Self-citationHome and ambulatory blood pressure monitoring in chronic kidney disease
Agarwal, R. (2009) · Current opinion in nephrology and hypertension · doi:10.1097/mnh.0b013e3283319b9d · Cited by 41 · see citing works
White, W. B., Lacourcière, Y., Gana, T. J., Pascual, M. L. G., Smith, D. H. G., & Albert, K. S. (2004) · American Heart Journal · doi:10.1016/j.ahj.2004.07.008 · Cited by 29 · see citing works
Ishikawa, J., Shimizu, M., Hoshide, S., Eguchi, K., Pickering, T. G., Shimada, K., & Kario, K. (2008) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2008.00018.x · Cited by 28 · see citing works
Is blood pressure during the night more predictive of cardiovascular outcome than during the day?
Li, Y., Boggia, J. G., Thijs, L., et al. (2008) · Blood Pressure Monitoring · doi:10.1097/mbp.0b013e3282fd16cc · Cited by 19 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [4]Feldman HI Appel LJ Chertow GM The Chronic Renal Insufficiency Cohort (CRIC) Study: Design and Methods J Am Soc Nephrol 2003 14 S148 S153 12819321
- [10]Staessen JA Thijs L Fagard R O’Brien ET Clement D de Leeuw PW Mancia G Nachev C Palatini P Parati G Tuomilehto J Webster J Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators JAMA 1999 282 539 546 10450715
- [25]Townsend RR Ford V Ambulatory blood pressure monitoring: coming of age in nephrology J Am Soc Nephrol 1996 7 2279 2287 8959618
Cited by
Sorted by citations
Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., Myers, M. G., Ogedegbe, G., Schwartz, J. E., Townsend, R. R., et al. (2019) · Hypertension · doi:10.1161/hyp.0000000000000087 · Cited by 1,512 · see citing works
Self-citation10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Das, S. R., Hilliard, M. E., Isaacs, D., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s010 · Cited by 465 · see citing works
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Das, S. R., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s010 · Cited by 339 · see citing works
- Authors
- Rahman, M., Greene, T., Phillips, R. A., Agodoa, L. Y., Bakris, G. L., Charleston, J., Contreras, G., Gabbai, F., Hiremath, L., Jamerson, K., Kendrick, C., Kusek, J. W., Lash, J. P., Lea, J., Miller, E. R., Rostand, S., Toto, R., Wang, X., Wright, J. T., & Appel, L. J.
- Affiliations
- National Institutes of Health (US)
- ORCID
- Venue
- Hypertension
- Published
- 2013-01
- Volume
- 61
- Issue
- 1
- Pages
- 82-88
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC3523681
- OpenAlex
- W2062987880
- Cited by
- 93
- References
- 29
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 17 · 2020: 9 · 2019: 7 · 2018: 7 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 5 · 2013: 6
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000439)
- National Center for Research Resources (M01RR000080)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- nocturnal blood pressure, chronic kidney disease, African Americans, bedtime dosing, diltiazem, hydralazine, ramipril, ambulatory blood pressure monitoring
- MeSH terms
- Aged, Aged, 80 and over, Antihypertensive Agents, Black or African American, Blood Pressure, Diltiazem, Drug Administration Schedule, Drug Therapy, Combination, Female, Glomerular Filtration Rate, Heart Rate, Humans, Hydralazine, Hypertension, Male, Middle Aged, Treatment Outcome, Ramipril, Cross-Over Studies, Blood Pressure Monitoring, Ambulatory, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
