Hypertensive patients can have better control of their condition, and lower risk of adverse events by taking medications last thing at night rather than in the morning, researchers report today.
Professor Ramon Hermida at the University of Vigo, Spain, and colleagues tested whether “bedtime in comparison to usual upon-awakening hypertension therapy exerts better cardiovascular disease risk reduction”.
They recruited 19,084 hypertensive men and women, who were randomly assigned to take their hypertension medications at bedtime or upon awakening. They were followed for about six years. During this time, 1,752 participants experienced the primary outcome (cardiovascular death, heart attack, coronary revascularisation, heart failure, or stroke).
Those who took their medication at bedtime had a significantly lower risk of a cardiovascular outcome, once several factors were taken into account, including age, sex, type 2 diabetes, and previous cardiovascular event.
In particular, they had a 56% lower risk of cardiovascular death, a 34% lower risk of heart attack, a 40% lower risk of coronary revascularisation, a 42% lower risk of heart failure, and a 49% lower risk of stroke.
Professor Hermida said: “Current guidelines on the treatment of hypertension do not mention or recommend any preferred treatment time. Morning ingestion has been the most common recommendation by physicians based on the misleading goal of reducing morning blood pressure levels.
“However, this study shows that patients who routinely take their anti-hypertensive medication at bedtime, as opposed to when they wake up, have better-controlled blood pressure and, most importantly, a significantly decreased risk of death or illness from heart and blood vessel problems.”
Hermida, R. C. et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. European Heart Journal 23 October 2019; doi: 10.1093/eurheartj/ehz754
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehz754
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