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Hype and hope of bedtime dosing of antihypertensives: better to sleep on it?
  1. Teck K Khong, DTB Associate Editor
  1. Clinical Pharmacology, St George's University of London, London, UK
  1. Correspondence to Dr Teck K Khong, Clinical Pharmacology, St George's University of London, London, UK; tkhong{at}

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As humanity battles the COVID-19 pandemic, it has looked to science for answers—leading perhaps to sometimes over-enthusiastic, premature and even false pronouncements of progress, breakthroughs and success. This is not unique to the current situation. When the Hygia Chronotherapy Trial was published, shortly before SARS-CoV-2 appeared, its results were widely trailed in the medical and mainstream media with great interest from patients.1 The trial reported that people who took antihypertensive medication at bedtime compared with on waking had a 45% lower risk of a cardiovascular event, with related deaths more than halved. This prospective randomised trial with an average follow-up of 6 years included 19 084 patients of whom 1752 experienced the main cardiovascular outcome. Thus, on the face of it, the study appeared to share hallmarks of many high-profile cardiovascular trials that have helped to shape clinical practice. …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.