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Time-dependent effects of aspirin on blood pressure and morning platelet reactivity: a randomized cross-over trial

Tobias N Bonten1, Jaapjan D Snoep2, Willem J J Assendelft2

  • 1From the Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands (T.N.B., J.D.S., F.R.R., J.G.v.d.B.); Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands (W.J.J.A.); Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands (W.J.J.A.); JJ van Rood Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands (J.J.Z., J.G.v.d.B.); and Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands (J.E., M.V.H.). t.n.bonten@lumc.nl.

Hypertension (Dallas, Tex. : 1979)
|February 19, 2015
PubMed

Insights

Taking low-dose aspirin at bedtime did not lower blood pressure in cardiovascular disease patients. However, bedtime aspirin did reduce morning platelet reactivity, potentially lowering cardiovascular event risk during high-risk morning hours.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Daily aspirin intake is common for cardiovascular disease (CVD) prevention.
  • Previous research suggested bedtime aspirin may lower blood pressure.
  • Morning hours are associated with peak platelet reactivity and CVD events.

Purpose of the Study:

  • To investigate the effect of bedtime aspirin versus morning aspirin on 24-hour blood pressure and morning platelet reactivity in CVD patients.
  • To determine if timing of aspirin intake influences cardiovascular risk markers.

Main Methods:

  • Randomized, open-label, crossover trial involving 290 patients with CVD.
  • Patients took 100 mg aspirin at bedtime or on awakening for 3-month periods.
  • Measurements included 24-hour ambulatory blood pressure and morning platelet reactivity.

Main Results:

  • Bedtime aspirin did not significantly reduce systolic or diastolic blood pressure compared to morning intake.
  • Aspirin taken at bedtime significantly reduced morning platelet reactivity by -22 aspirin reaction units.
  • The findings were based on primary analysis populations of 263 for blood pressure and 133 for platelet reactivity.

Conclusions:

  • Taking low-dose aspirin at bedtime does not lower blood pressure in patients with CVD.
  • Bedtime aspirin intake effectively reduces morning platelet reactivity.
  • Further research is warranted to evaluate if this timing strategy reduces morning cardiovascular events.

Keywords:
aspirinblood pressurechronotherapyplatelet activation

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