Changing the Timing of Antihypertensive Therapy to Reduce Nocturnal Blood Pressure in CKD: An 8-Week Uncontrolled Trial

Background Nondipping status is associated with greater cardiovascular morbidity and mortality and faster progression of chronic kidney disease (CKD). We examined whether shifting 1 antihypertensive drug from morning to evening restores the circadian rhythm of blood pressure in nondipper patients with CKD. Study Design 8-week clinical trial without a control group. Setting & Participants We selected from our outpatient renal clinic 32 patients with CKD with estimated glomerular filtration rate less than 90 mL/min/1.73 m2 and night-day ratio of mean ambulatory blood pressure (ABP) greater than 0.9, but with normal daytime ABP (