Bedtime Dosing of Antihypertensives May Improve Nighttime BP Control in Hypertension: OMAN Trial
China: A recent large-scale, multicenter randomized clinical trial has provided new insights into the optimal timing of antihypertensive medication, suggesting that taking blood pressure-lowering drugs at bedtime may offer superior control of nocturnal blood pressure (BP) and help restore normal circadian rhythms in patients with hypertension.
Published in JAMA Network Open, the study, known as the OMAN (Optimal Medication Administration for Nocturnal blood pressure) trial, was spearheaded by Dr. Runyu Ye and a team of researchers from the Department of Cardiology at West China Hospital, Sichuan University, Chengdu, China. Conducted across 15 hospitals in China, the trial enrolled 720 adult patients diagnosed with hypertension. The recruitment period spanned from June 1, 2022, to April 30, 2024, with each participant being followed up for a total of 12 weeks.
The core objective of the study was to compare the effects of morning versus bedtime dosing of antihypertensive medication on nighttime BP and circadian rhythm. The participants—none of whom had received antihypertensive therapy in the two weeks prior to the study—were randomly divided into two groups: one receiving medication in the morning (between 6:00 and 10:00 am), and the other at bedtime (between 6:00 and 10:00 pm). All patients were prescribed a daily combination pill containing 20 mg of olmesartan and 5 mg of amlodipine. Dosage modifications were allowed at the fourth and eighth weeks, depending on ambulatory and office BP measurements.
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