Blood pressure lowering drugs 'better taken before bed'
By Nigel Praities
Patients with hypertension have significantly better control of their blood pressure and other cardiovascular risk factors if they take their medication before going to bed, say researchers.
Their study found patients with resistant hypertension taking at least one antihypertensive before bedtime had significantly better blood pressure, glucose and cholesterol levels compared with those taking it after waking.
The Spanish researchers measured blood pressure in 1,700 patients taking three or more anti-hypertensives at 20 minute intervals during the day and at 30 minute intervals at night.
Those taking at least one antihypertensive drug at bedtime had significantly lower 24-hour mean systolic and diastolic blood pressure.
There were also significantly lower average values of LDL-cholesterol, total cholesterol, glucose, fibrinogen and urinary albumin secretion in the bedtime-dosing group.
The study – presented at the American Hypertension Society meeting in San Francisco this month - also found the prevalence of non-dipping in the group taking one medication at night reduced from 84.4% to 42.9%.
Professor Ramon Hermida, lead author and professor of bioengineering at the University of Vigo, Spain, said the research showed the importance of dose timing in this group of patients.
‘In patients with resistant hypertension, pharmacological therapy should take into account when to treat with respect to the rest-activity cycle of each patient,' he said.
Dr George Kassianos, a fellow of the European Society of Cardiology and a GP in Bracknell, Berkshire, urged caution about applying the conclusions of the study.
‘I would be reluctant to recommend patients to take their blood pressure medication at night in case they increase the problem of hypotension when our blood pressure drops normally,' he said.