Bedtime vs. morning aspirin intake on the diurnal variability of blood pressure and platelet aggregation for the prevention of coronary artery diseases: a systematic review and meta-analysis.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Alina Ghazou, Mayar El-Haddad, Amany Abdelaziz Hasan, Muhammad Ashraf Saleh, Tamer Ahmed Mahmoud, Abderrazzak Elomari, Manar Alaa Mabrouk, Mostafa AbdulSattar, Aya Abdul Fattah Taha
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引用次数: 0

Abstract

Purpose: Low-dose aspirin had been widely used for secondary prevention of cardiovascular disease. Chronopharmacology of arterial hypertension and platelet aggregation impacts the long-term thromboembolic risk in patients with cardiovascular disease. Therefore, clinical studies have proposed optimising aspirin dosing time. Therefore, the aim of this study is to investigate the effect of timing of administration of low dose aspirin on the mean blood pressure profile and platelet aggregation for primary and secondary prevention of cardiovascular disease.

Methods: The literature search included PubMed, Scopus, Web of Science, and Cochrane CENTRAL. The identification of included randomised controlled trials (RCTs) followed a systematic literature review (SLR) in accordance with the guidelines and recommendations of The Cochrane Collaboration. RCTs on the effect of aspirin intake at different times of the day on blood pressure and platelet aggregation in adults with coronary arterial disease or arterial hypertension for primary or secondary prevention were included.

Results: Meta-analysis included 11 RCTs out of 6495 studies. In terms of patients' characteristics, the overall mean age was 52.7, and 65% of the patients were men. The pooled mean differences of systolic and diastolic blood pressure were significant in the bedtime group in 'prehypertension and untreated hypertension' subgroup (MD = -8.20, 95% CI [-9.80, -6.61], MD = -4.02, 95% CI [-5.94, -2.11]; respectively) while no significant difference was seen in the 'treated hypertension and CVD' subgroup in both SBP and DBP (MD = -0.08, 95% CI [-2.65, 2.5], MD = -0.46, 95% CI [-2.20, 1.28]; respectively). The included studies demonstrating the effect of bedtime aspirin on platelet aggregation showed a significant reduction in platelet aggregation favouring the bedtime group with a mean difference of -21.15, 95% Cl [-32.78, -9.53].

Conclusion: The study shows an additional antihypertensive benefit of bedtime aspirin intake in the prehypertension and untreated hypertension groups, which may provide a positive long-term impact on cardiovascular risk in hypertensive patients. Moreover, the study revealed an additional benefit of bedtime aspirin intake on platelet aggregation, particularly in the morning hours when most thromboembolic events were found to occur.

睡前和早晨阿司匹林摄入对预防冠状动脉疾病的血压和血小板聚集的日变异性的影响:一项系统综述和荟萃分析
目的:小剂量阿司匹林已广泛应用于心血管疾病的二级预防。动脉高血压和血小板聚集的时间药理学影响心血管疾病患者的长期血栓栓塞风险因此,临床研究建议优化阿司匹林给药时间。因此,本研究的目的是探讨低剂量阿司匹林给药时间对心血管疾病一级和二级预防的平均血压和血小板聚集的影响。方法:文献检索包括PubMed、Scopus、Web of Science、Cochrane CENTRAL。确定纳入的随机对照试验(rct)遵循按照Cochrane协作网的指南和建议进行的系统文献综述(SLR)。纳入了在一天中不同时间摄入阿司匹林对成年冠状动脉疾病或动脉高血压患者血压和血小板聚集的影响的随机对照试验,用于一级或二级预防。结果:meta分析纳入了6495项研究中的11项rct。在患者特征方面,总体平均年龄为52.7岁,男性占65%。睡前组“高血压前期和未治疗高血压”亚组收缩压和舒张压合并平均差异显著(MD = -8.20, 95% CI [-9.80, -6.61], MD = -4.02, 95% CI [-5.94, -2.11];而“治疗高血压和心血管疾病”亚组的收缩压和舒张压均无显著差异(MD = -0.08, 95% CI [-2.65, 2.5], MD = -0.46, 95% CI [-2.20, 1.28];分别)。纳入的研究表明,睡前服用阿司匹林对血小板聚集的影响显示,睡前组血小板聚集明显减少,平均差异为-21.15,95% Cl[-32.78, -9.53]。结论:该研究显示,在高血压前期和未治疗的高血压组中,睡前服用阿司匹林具有额外的降压益处,这可能对高血压患者心血管风险产生积极的长期影响。此外,该研究还揭示了睡前服用阿司匹林对血小板聚集的额外益处,特别是在发现大多数血栓栓塞事件发生的早晨。
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来源期刊
Acta cardiologica
Acta cardiologica 医学-心血管系统
CiteScore
2.50
自引率
12.50%
发文量
115
审稿时长
2 months
期刊介绍: Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.
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