This Week in Cardiology: Antihypertensive Dosing Timing and SGLT2 Inhibitor Outcomes

Clinical considerations regarding the timing of antihypertensive administration were explored this week. In a meta-analysis published in the International Journal of Cardiology, researchers compared bedtime versus morning dosing across randomized trials ^[1].

The authors reported that no evidence was found of a difference in major adverse cardiovascular events between the two dosing schedules, suggesting that clinicians may consider patient preference when determining timing ^[1].

Regarding interventional techniques, research published in The New England Journal of Medicine examined the role of intravascular ultrasound (IVUS) during complex procedures. One randomized controlled trial involving 2020 patients undergoing complex PCI found a target-vessel failure rate of 13.9% for IVUS-guided PCI compared to 11.1% for angiography-guided PCI ^[2].

In a separate study also published in The New England Journal of Medicine, researchers evaluated 806 patients with unprotected left main coronary artery disease and found that IVUS-guided PCI did not significantly differ from angiography-guided PCI regarding primary outcomes ^[3].

We also saw research regarding the role of SGLT2 inhibitors in various cardiac conditions. A narrative review in Frontiers in Medicine examined empagliflozin and dapagliflozin, with authors concluding that while these agents provide robust prognostic benefits in heart failure, results regarding their effects on atrial arrhythmias remain less certain ^[4].

Additionally, a meta-analysis published in Heart Failure Reviews looked specifically at heart transplant recipients with type 2 diabetes. The researchers found that SGLT2 inhibitor use was associated with a lower risk of all-cause mortality and stable renal function in this specific patient population ^[5].