Bedtime Medications Offer Better BP Control in CKD

Taking at least one medication at bedtime reduces sleep-time, ambulatory BP, cardiovascular events

WEDNESDAY, Oct. 26 (HealthDay News) -- For patients with chronic kidney disease (CKD), taking at least one hypertension medication at bedtime results in better blood pressure (BP) control compared to morning medication, according to a study published online Oct. 24 in the Journal of the American Society of Nephrology.

Ramón C. Hermida, Ph.D., from the University of Vigo in Spain, and colleagues investigated whether the timing of ingestion of antihypertensive medications affects clinical outcomes in 661 patients with CKD. Patients were randomly allocated to take all prescribed antihypertensives upon awakening or to take at least one of them at bedtime. Measurement of 48-hour ambulatory BP was performed at baseline and three months after any adjustment in treatment, or at least annually during a median follow-up period of 5.4 years.

The investigators found that, compared to patients who took all their medications upon awakening, patients taking at least one antihypertensive at bedtime had a significantly reduced adjusted risk for total cardiovascular events (adjusted hazard ratio [HR], 0.31). There was also a significantly reduced risk for a composite outcome of cardiovascular death, myocardial infarction, and stroke (adjusted HR, 0.28) with bedtime dosing. Bedtime dosing was also associated with significantly lower mean sleep-time BP, and control of ambulatory BP was seen in a greater proportion of patients. Each 5-mm Hg decrease in mean sleep-time systolic BP was associated with a significant 14 percent decrease in cardiovascular risk.

"Among patients with CKD and hypertension, taking at least one antihypertensive medication at bedtime improves control of BP and reduces the risk for cardiovascular events," the authors write.

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