Evidence mapPaperPMID 41523855Full record

ReviewHealth science reports2026

The Effect of Chronotherapy on Clinical Outcomes in Hypertensive Patients: A Systematic Review and Meta-Analysis Comparing Bedtime Versus Morning Dosing of Antihypertensive Drugs.

Pouria Azami, Alireza Hosseinpour, Ehsan Zandi, Farshad Rajabi, Alireza Mirhosseini, Sarvenaz Farhangdoust, Armin Attar

Abstract readReview
In one paragraph

Review in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Pouria AzamiSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.ORCID https://orcid.org/0000-0001-8563-6005
Alireza HosseinpourSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.ORCID https://orcid.org/0000-0002-4175-8059
Ehsan ZandiSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.
Farshad RajabiSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.
Alireza MirhosseiniCardiovascular Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran.ORCID https://orcid.org/0009-0000-3920-8640
Sarvenaz FarhangdoustSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.
Armin AttarSchool of Medicine Shiraz University of Medical Sciences Shiraz Iran.ORCID https://orcid.org/0000-0002-4133-4870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: This systematic review and meta-analysis aimed to compare the clinical outcomes of antihypertensive medication administration at bedtime versus morning, focusing on major adverse cardiovascular events (MACE), mortality, and secondary cardiovascular outcomes in hypertensive patients. Methods: We conducted a systematic search across multiple databases to identify randomized controlled trials (RCTs) comparing bedtime versus morning antihypertensive dosing. Studies were included if they evaluated MACE, all-cause mortality, or cardiovascular mortality. Myocardial infarction, stroke, and heart failure were considered secondary outcomes. Data were extracted, and statistical analysis was performed using hazard ratios and mean differences with 95% confidence intervals. A random-effects model with Hartung-Knapp correction was used to account for between-study heterogeneity. Sensitivity analyses were conducted to assess the robustness of the results. Results: Five studies with 36,477 patients (42.30% male) were included. No significant differences were found between bedtime and morning dosing for MACE (HR: 0.71, 95% CI: 0.43-1.15, Conclusion: This meta-analysis found no significant difference in cardiovascular outcomes between bedtime and morning antihypertensive dosing. Within the limitations of the available evidence, a universal chronotherapy strategy does not appear to provide additional cardiovascular benefit. Once-daily antihypertensive medications can be taken at a time that aligns with the patient's lifestyle, with adherence being the most critical factor in ensuring treatment effectiveness.

Indexed as

antihypertensive medicationsbedtime dosingcardiovascular outcomeschronotherapyhypertension

Identifiers

PMID41523855
PMCPMC12783704

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.