BACKGROUND: Nondipping status is associated with greater @entity65 and mortality and faster progression of @entity740 ( @entity740 ). We examined whether shifting 1 antihypertensive drug from morning to evening restores the circadian rhythm of blood pressure in nondipper @entity1 with @entity740 . STUDY DESIGN: 8-week clinical trial without a control group. SETTING _ @entity1 : We selected from our outpatient renal clinic 32 @entity1 with @entity740 with estimated glomerular filtration rate less than 90 mL/ @entity1009 .73 m(2) and night-day ratio of mean ambulatory blood pressure (ABP) greater than 0.9, but with normal daytime ABP (<135/85 mm Hg) to avoid the required therapy intensification. INTERVENTION: Shifting 1 antihypertensive drug from morning to evening. OUTCOMES: Percentage of @entity1 changing the night-day ratio of mean ABP from greater than 0.9 to 0.9 or less 8 weeks after the shift. MEASUREMENTS: Office blood pressure/ABP and @entity644 at baseline and after the shift. RESULTS: There were 55% @entity1 with a mean age of 67.4 +/- 11.3 years and estimated glomerular filtration rate of 46 +/- 12 mL/ @entity1009 .73 m(2). They were treated with 2.4 +/- 1.4 antihypertensive drugs. After the drug shift, the night-day ratio of mean ABP decreased in 93.7% of @entity1 , with normal circadian rhythm restored in 87.5%. The nocturnal systolic and diastolic ABP decrease was not associated with an increase in diurnal ABP and was independent from number and class of shifted drug. Office blood pressure in the morning also decreased (from 136 +/- 16/77 +/- 10 to 131 +/- 13/75 +/- 8 mm Hg; P = 0.02). Urinary protein excretion decreased from 235 +/- 259 to 167 +/- 206 mg/d (P < 0.001). LIMITATIONS: Absence of a control group and @entity1 with severe @entity644 or uncontrolled daytime ABP. CONCLUSIONS: In nondipper @entity1 with @entity740 , changing the timing of antihypertensive therapy decreases nocturnal blood pressure and @entity644 .

Changing the timing of antihypertensive therapy to reduce nocturnal blood pressure in XXXX : an 8-week uncontrolled trial.

@entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS', 'men'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity1009 :: ('966', 'Gene') :: ['min/1'] @entity740 :: ('MESH:D051436', 'Disease') :: ['CKD', 'chronic kidney disease'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular morbidity']
@entity740 :: (MESH:D051436,Disease) :: ['CKD']
