Blood pressure medicines may work better if they are taken at night.
Spanish researchers randomized 19,084 men and women with diagnoses of high blood pressure, half to take their medicine at bedtime and the other half when they awoke. Over a six-year follow-up, there were 3,246 coronary events — stroke, heart attack, heart failure, angina and others — and 310 deaths from cardiovascular disease.
The study, in the European Heart Journal, controlled for age, sex, number and type of blood pressure medicines, sleep apnea, smoking, diabetes, obesity, cholesterol and dozens of other cardiovascular risk factors.
Compared with those who took their medicine in the morning, those who took it at night were 43 percent less likely to have any cardiovascular event. Their risk for stroke was 49 percent lower, for heart attack 34 percent lower, and for heart failure 42 percent lower. Bedtime users had a 45 percent lower risk for death from any cause, and a 56 percent lower risk for death from cardiovascular disease.
The study also found that bedtime therapy was associated with improved kidney function and healthier cholesterol levels.
“The results were highly significant regardless of age or sex,” said the lead author, Ramón C. Hermida, a professor of biomedical engineering at the University of Vigo in Spain. Check with your doctor before changing your medication routine. But taking medicine at bedtime, he said, “is a cost-free intervention that can be directly applicable to all hypertensive patients.”