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Cited by 16Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionSodium Intake and Health

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Dosing Time Matters? Nighttime vs. Daytime Administration of Nifedipine Gastrointestinal Therapeutic System (GITS) or Amlodipine on Non-dipper Hypertension: A Randomized Controlled Trial of NARRAS

Open access
Liu, Jing, Su, Xiaofeng, Nie, Ying, Zeng, Zhihuan, Chen, Hongyan·2021·Frontiers in Cardiovascular Medicine
DOI 10.3389/fcvm.2021.755403PMC PMC8666540
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Abstract

Background: Non-dipper hypertension is often characterized by a blunted decrease of nocturnal blood pressure (BP) and is associated with increased risk of target organ damage and cardiovascular (CV) events, while the optimal treatment strategy is yet to be established. This trial was designed to evaluate whether nocturnal BP reduction and arterial stiffness improvement differ from antihypertensive agents and time of administration. Methods: Young and middle-aged adults (18–65 years) with non-dipper hypertension were randomly assigned to nifedipine GITS (gastrointestinal therapeutic system) 30 mg or amlodipine besylate 5 mg once daily for 8 weeks, either taken in the morning or at night. Dose was doubled at 4-week if BP is not at goal. Twenty-four hour ambulatory BP monitoring (ABPM) and arterial stiffness were evaluated before and after 8 weeks of pharmacotherapy. The primary efficacy measure was the average nighttime systolic BP reduction. Results: A total of 98 non-dipper hypertensive patients (mean age 46.3 years) were randomized during Dec, 2016 and Dec, 2020, of whom 72 (73%) patients completed all ABPM and follow-up evaluations. Nighttime systolic BP significantly reduced at 8 weeks vs. baseline with nifedipine GITS or amlodipine, irrespective of dosing at nighttime (−9.9 vs −9.9 mmHg, P > 0.05) or daytime (−11.5 vs. −10.9 mmHg, P > 0.05). No difference was seen between these two agents, when combining the data of nighttime and daytime dosing together (−10.8 vs. −10.5 mmHg, respectively, P = 0.898). Daytime, 24-h systolic BP, diastolic BP at different time and pulse wave velocity reduced significantly and comparably, and recovery of dipping rhythm were similar among groups. Conclusion: Nighttime dosing of long-acting antihypertensive preparations, nifedipine GITS or amlodipine demonstrated similar effects on nocturnal BP reduction, dipping rhythm restoration and arterial elasticity improvement in younger subjects with non-dipper hypertension. These effects were comparable with morning dosing.

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Figures

Figure 1 Flowchart of the trail. A-M, amlodipine in the morning; A-N, amlodipine at night; N-M, nifedipine GITS in the morning; N-M, nifedipine GITS at night; GITS, gastrointestinal therapeutic system; ITT, intention-to-treat; PP, per-protocol.
Figure 1 Flowchart of the trail. A-M, amlodipine in the morning; A-N, amlodipine at night; N-M, nifedipine GITS in the morning; N-M, nifedipine GITS at night; GITS, gastrointestinal therapeutic system; ITT, intention-to-treat; PP, per-protocol.CC BY · PubMed Central

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Metadata

Authors
Liu, J., Su, X., Nie, Y., Zeng, Z., & Chen, H.
Affiliations
  • Peking University People's Hospital (CN)
  • Beijing Jiaotong University (CN)
  • First Affiliated Hospital of Guangdong Pharmaceutical University (CN)
  • North China Electric Power University (CN)
Corresponding author
Liu, Jing
ORCID
Venue
Frontiers in Cardiovascular Medicine
Publisher
Frontiers Media SA
Published
2021-11-29
Volume
8
Pages
755403-755403
ISSN
2297-055X (ISSN-L)
DOI
10.3389/fcvm.2021.755403
PMC
PMC8666540
OpenAlex
W3215275916
Cited by
16
References
38
Citations by year
2026: 4 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Cardiovascular Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Funders
Bayer HealthCare
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
non-dipper hypertension, amlodipine, time of administration, nighttime dosing, nocturnal blood pressure dipping, arterial stiffness, pulse wave velocity, ambulatory blood pressure monitoring, calcium channel blockers, young and middle-aged adults, cardiovascular risk reduction

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