According to new research, taking blood pressure medications before going to bed may help reduce the risk of heart disease-related deaths rather than taking them in the morning.
The study published Tuesday in the European Heart Journal looked at more 19,000 patients with high blood pressure (hypertension) and found that antihypertensive drugs work overnight when patients are asleep, reducing the risk of heart disease-related death by half.
Lead study author Ramón Hermida said, “The same medication ingested at different times of the day actually has different pharmacological properties, behaving like totally different medications.”
Hermida and his colleagues advised half of the participants to take their blood pressure meds first thing in the morning, while the other half were advised to take their meds at bedtime, for six years, with periodic monitoring of their blood pressure.
The researchers were surprised by the difference in the results. Participants who took their blood pressure pills at night had more than 40 percent lesser risk of having a stroke, heart attack, or heart failure than participants who took their meds in the morning. The researchers also found that night-timers had a lower risk of needing procedures to treat blocked coronary arteries.
In addition, night-timers had a 66 percent lower risk of dying from cardiovascular disease during the six-year study period.
Hermida explained that you are preventing hypertension during sleep by taking the medications before going to bed.
A person normally experiences a dip in the blood pressure by approximately 10 to 20 percent at night, which is described as “nocturnal dipping.”
However, that may not happen in some people and others may have an increase in blood pressure while asleep, according to Cleveland Clinic Cardiologist, Dr. Luke Laffin, who was not part of the new study.
“It makes sense that if we give blood pressure medicines at night, we may catch some of those people who have the nondipping patterns, or elevated blood pressures at night and protect them from more cardiovascular disease,” said Dr. Laffin.
While the study results have been promising, some researchers explained that patients with hypertension should first check with their doctors before changing to their antihypertensive therapy routine.
Dr. Tim Chico from the University of Sheffield in the UK said, “It is important to understand that this may not apply to medications that need to be taken more than once a day, or for blood pressure medications that are being prescribed for other problems such as angina.” However, some people may not prefer taking certain types of antihypertensive at night, for instance, diuretics, as they cause increased urination. The findings also may not apply to people who are awake all night, such as shift workers.
