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Friday, 25 October 2019

Taking blood pressure drugs at night may make them more effective

Taking blood pressure drugs at night may make them more effective

Taking blood pressure medication before bed seems to make it more effective

Medication for high blood pressure is more effective when taken at bedtime than the following morning. Knowing the best time to take such drugs is important, because lowering your blood pressure reduces the chances of developing conditions such as heart attacks and strokes by 45 per cent.

Ramón Hermida at the University of Vigo in Spain and his colleagues randomly split 19,000 men and women with high blood pressure into two groups. The team asked half of the people to take their medication before they went to bed and the other half to take it when they woke up.

Each individual recorded their sleep patterns and had follow-up visits to take their blood pressure and check for any side effects. They were monitored for six years on average.

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The team found that those who took their dose at bedtime had lower blood pressure during sleep than those who took it the morning after. These reduced levels were linked to a lower risk of heart conditions: the total number of heart conditions in the bedtime group was 43 per cent less than the morning group.

Previous research has shown that blood pressure during sleep is a good indicator of potential heart conditions. High blood pressure at night signals a problem, regardless of whether it was normal during the day. Taking the medication before sleeping, when blood pressure is naturally lower, might boost its effects by tapping into people’s natural body clock.


This could explain why participants who took their medication at bedtime saw a continued fall in their sleeping blood pressure over the course of the trial, even accounting for factors that usually increase chances of becoming ill, such as old age and diabetes.

This group also experienced a decreased risk of heart conditions, which was about 45 per cent lower than those taking their medication in the morning.

Daytime measurements alone aren’t enough, because they could misrepresent someone’s actual blood pressure, leading to a misdiagnosis, says Hermida.

Instead, blood pressure should ideally be monitored over a 24-hour period to consider our lifestyles and give the most complete picture, he says.

Candace McNaughton at Vanderbilt University in Nashville, Tennessee, says the work may help patients make the most of their medication, but that the impact may depend on how serious your condition is.

“The benefit was greatest for those who had not been treated in the past and for those who did not already have a history of cardiovascular events. In other words, the patients who benefitted the most were the healthiest,” she says.

Journal reference: European Heart Journal, DOI: 10.1093/eurheartj/ehz754

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