{
  "abstract": "Mean blood pressure (BP) differences do not fully characterize treatment response. We examined adjusted BP, target attainment and change distributions after morning versus bedtime antihypertensive dosing. This post hoc secondary analysis of a randomized controlled trial included 60 patients with uncontrolled hypertension and a nondipping pattern, assigned to morning or bedtime dosing (30 per group). Two‐month systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) were compared using baseline‐adjusted analysis of covariance. Secondary analyses assessed BP <140/90 mmHg and median and trimmed changes. Adjusted bedtime‐minus‐morning differences were −18.1 mmHg for SBP (95% CI −22.4 to −13.8), −11.6 mmHg for DBP (−14.5 to −8.8) and −13.9 mmHg for MAP (−16.7 to −11.0); all p < 0.001. Bootstrap intervals were similar. BP <140/90 mmHg was achieved by 29/30 (96.7%) versus 3/30 (10.0%) patients (risk ratio 9.67; 95% CI 3.30–28.34). Median SBP and DBP change differences were −9.5 and −3.0 mmHg, respectively, with confidence intervals including zero. Bedtime dosing was associated with lower adjusted two‐month BP and greater target attainment. Change‐based estimates were less precise, indicating uncertainty about the distribution of response. These exploratory findings from a small randomized trial warrant prospective confirmation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine B Ziv Medical Center Safed Israel",
    "Azrieli Faculty of Medicine Bar‐Ilan University Safed Israel",
    "Laboratory For Industrial and Applied Mathematics Department of Mathematics and Statistics York University Toronto Ontario Canada",
    "Postgraduate School of Public Health Department of Health Sciences University of Genoa Genoa Italy",
    "UNESCO Chair Health Anthropology Biosphere and Healing Systems University of Genoa Genoa Italy",
    "Physical Education and Sports Teaching Department Faculty of Sports Sciences Atatürk University Erzurum Türkiye",
    "Clalit Health Services Akko Israel",
    "Azrieli Faculty of Medicine Bar‐Ilan University, Galilee Safed Israel"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Raymond Farah"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Nicola Luigi Bragazzi"
    },
    {
      "affs": [
        5
      ],
      "name": "Halil Ibrahim Ceylan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Nader Ballout"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Tony Hanna"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Rola Khamisy‐Farah"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/athcf46671dgg.bib",
  "cited_by": 0,
  "doi": "10.1111/jch.70372",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13700106/",
  "id": "athcf46671dgg",
  "issns": [
    "1524-6175",
    "1751-7176"
  ],
  "landing_url": "https://doi.org/10.1111/jch.70372",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2705|Blood Pressure and Hypertension Studies"
    ]
  ],
  "openalex": "W7223658401",
  "pdf_url": "https://europepmc.org/articles/PMC13700106?pdf=render",
  "pmcid": "PMC13700106",
  "pmid": "42929421",
  "published": "2026-10-01",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/athcf46671dgg.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "PMC13700106",
      "source": "pmc",
      "url": "https://doi.org/10.1111/jch.70372"
    },
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42929421",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42929421"
    },
    {
      "first_seen": "2026-10-31T14:22:42Z",
      "native_id": "8c7e5e73c3774b32a81aa65a09cecbd4",
      "source": "doaj",
      "url": "https://doi.org/10.1111/jch.70372"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Blood Pressure and Hypertension Studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Beyond Mean Blood Pressure Reduction: Distributional and Responder Effects of Bedtime Antihypertensive Dosing in Nondipping Hypertension. A Secondary Analysis of a Randomized Controlled Study",
  "title_text": "Beyond Mean Blood Pressure Reduction: Distributional and Responder Effects of Bedtime Antihypertensive Dosing in Nondipping Hypertension. A Secondary Analysis of a Randomized Controlled Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T14:20:40Z",
  "url": "https://research.draconitic.com/paper/athcf46671dgg",
  "venue": "The Journal of Clinical Hypertension",
  "versions": []
}