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Putting night-time dosing of antihypertensives to bed for now
  1. Teck K Khong
  1. Blood Pressure Unit, St George’s Hospital, 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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In 2019, the results of the Hygia Chronotherapy Trial were widely trailed by the medical and mainstream media.1 The authors of the study suggested that antihypertensive medication taken at bedtime compared with on waking could halve cardiovascular disease and related deaths. It provoked great interest from practitioners and patients, prompting some to urge colleagues to make changes to their practice.2 It is of course vital that significant clinical advances are publicised to reach as wide an audience as possible. It is equally important though that research findings do not get mistaken as progress in practice. As with many exciting newsworthy scientific findings, what was less well reported with the Hygia trial was the detailed analysis of the data and the controversy surrounding its findings.

Following publication, the magnitude of benefit—which remarkably also included major reductions in non-cardiovascular deaths—by the simple manoeuvre of changing the timing of dosing of antihypertensive medications was met …

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