Nightly Blood Pressure Dosing Improves Outcomes

Shifting one or more medications to evening improves BP control, reduces CVD
By Beth Gilbert
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- Administration of at least one blood pressure (BP) medication at night instead of upon waking appears to significantly improve BP control, decrease the prevalence of non-dipping, and reduce cardiovascular disease (CVD) morbidity and mortality, according to a study published in the September issue of Chronobiology International.

Ramon C. Hermida, Ph.D., of the University of Vigo in Spain, and colleagues randomized 2,156 hypertensive individuals (1,044 men and 1,112 women) to ingest all their prescribed hypertension medications upon awakening or at least one of them at bedtime.

Despite the lack of differences in ambulatory BP between the groups at baseline, the investigators found that ingesting medication at bedtime was associated with significantly lower mean sleep-time BP, higher sleep-time relative BP decline, reduced prevalence of non-dipping, and higher prevalence of controlled ambulatory BP. Compared with individuals ingesting all medications upon awakening, those ingesting at least one BP-lowering medication at bedtime exhibited a significantly lower relative risk of total CVD events and major events, including death, at a median 5.6 years of follow-up.

"Most importantly, this study shows that a bedtime chronotherapeutic strategy prevents or retards the progression of target organ damage and significantly reduces CVD risk," the authors of an accompanying editorial write.

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