Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Mindy Staveteig


Chronotherapy in hypertension; Chronotherapy in hypertension with CKD; Chronotherapy in diabetes; Chronotherapy of ACE inhibitors; Chronotherapy of angiotensin II receptor blockers


The purpose of this research is to compare p.m. dosing outcomes of angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor blockers (ARBs) in those with hypertension and hypertension with chronic kidney disease and diabetes. In this review, three databases were utilized including PubMed, ClinicalKey, and DynaMed with a time frame of 15 years. Studies chosen for review were peer reviewed, and included randomized control trials, systematic reviews, meta-analyses, and a preclinical animal trial. There were several studies excluded because they did not focus on ACE inhibitors or ARBs, or they did not focus on the disease processes intended for research in this project. Other studies that included dosing ACE inhibitors or ARBs at night and in the morning per participant were also excluded because this project focuses on the effects of using one methodology verses the other. Therefore 17 articles met the final criteria. The research shows evidence of reduced blood pressures throughout the night and into the next day, decreased proteinuria, and decreased cardiovascular events when dosing ACE inhibitors or ARBs at night, or dosing at least one antihypertensive medication at night. This research shows beneficial evidence and no documented adverse patient reactions when dosing ACE inhibitors or ARBs at night. However, further research needs to be conducted with larger patient populations to make official recommendations in those with hypertension and hypertension with diabetes or chronic kidney disease.