Is night time right time for blood pressure meds?

Blood pressure pills offer more protection when taken before bed, a large new study suggests.

There is mounting evidence that many different drugs, including heart pills, might work better when taken at specific times of the day and, according to the European Heart Journal, it’s a simple tip that could save lives.

Experts believe the body’s biological ‘clock’ or natural 24-hour rhythm alters response to a medication. The latest Spanish trial is the largest to date to look at this phenomenon with high-blood-pressure pills.

In the study, involving more than 19,000 people taking these medications:

  • The patients were put into two groups at random, with one group taking the pills in the morning and the other group taking them at bedtime.
  • Researchers monitored what happened to the patients over the next five or more years.
  • Patients who took their medication in the evening had nearly half the risk of dying from – or having – a heart attack, stroke or heart failure.

Experts say blood pressure should naturally dip at night as we rest and sleep. If it doesn’t, and remains consistently high, it puts the person at increased risk of heart attacks and strokes.

The research suggests taking medication in the evening helps keep night-time blood pressure in check, in patients diagnosed with hypertension.

Patients in the study who took their medication at bedtime had significantly lower average blood pressure both at night and during the day, and their blood pressure dipped more at night, when compared with patients taking their medication each morning.

Lead researcher from Spain’s University of Vigo, Professor Ramon Hermida, said doctors might want to consider recommending this approach to patients.

“It’s totally cost free and it might save a lot of lives”, he said.

“Current guidelines on the treatment of hypertension do not 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.

“The results of this study show 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.”

Professor Hermida said more studies in different populations are needed to check that the findings will apply to all patients on different brands of blood pressure tablets.

British Heart Foundation spokesperson Vanessa Smith said: “While this study supports previous findings in this area, further research among other ethnic groups and people who work shift patterns would be needed to truly prove if taking blood pressure medication at night is more beneficial for cardiovascular health.

Ms Smith advised patients currently taking blood pressure medication to check with their GP or pharmacist before changing the time of dosing.

“There may be specific reasons why your doctor has prescribed medication in the morning or night,” she said.

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