TDNet Discover

Background: Chronotherapy is a novel approach to medication management which utilizes the body’s circadian clock to better treat disease states. Aspirin, a key medication in the management of cardiovascular disease, inhibits platelet production and decreases blood pressure, two measures influenced by the circadian clock. It has been proposed that aspirin administration at nighttime may increase effectiveness, however definitive studies and conclusions have not been made. Objective: This study reviewed the current literature on timing of aspirin administration to determine if it warrants a change to the current dosage recommendations for daily aspirin therapy. Methods: A systematic review of the literature regarding timing of aspirin administration was performed by searching all available abstracts through three databases: PubMed, Google Scholar, and CINAHL. Final selection of articles depended on full text review, adherence to inclusion and exclusion criteria, as well as consensus among three individual researchers. In total, 4 articles were selected and assessed according to the National Heart, Lung and Blood Institute quality assessment tool. Resultant data from each article was stratified by platelet aggregation, ambulatory blood pressure and survivability;two explored platelet aggregation, one explored ambulatory blood pressure and one explored all three major outcomes. Results: Database review produced four viable studies that investigated morning versus evening administration among a total of 209 patients. These studies showed a positive improvement in cardiovascular outcomes with evening administration such as reduction in ambulatory blood pressure and increased platelet inhibition;however, no evidence was found that demonstrated reduction in long term mortality.