Vigo (AP) - Many people with high blood pressure take their medication in the morning. According to a recent analysis, it can often be cheaper to swallow it before going to bed in the evening.
The blood pressure values obtained are then better on average, the researchers report in the "European Heart Journal". As a result, the risk of serious sequelae dropped significantly. It is recommended to have the ideal time determined by a long-term blood pressure measurement.
People with high blood pressure usually need to take medication daily. These keep the values throughout the day and even lower at night. A Spanish team of researchers headed by Ramón Hermida from Vigo University has now been researching when to use antihypertensives in more than forty medical centers in Spain as part of the Hygia research project. Other factors such as age, diabetes, kidney disease, smoking and cholesterol levels were excluded.
Of the more than 19,000 subjects with high blood pressure, half took the medication in the evening, the rest after waking up. For a good six years or more, physicians checked their blood pressure at least once a year - using blood pressure monitors that kept patients on their bodies for over 48 hours. It showed that the group, which took their medication in the evening, scored better. The average blood pressure during the day and at night was lower in this group and the values decreased more during sleep.
The researchers also found that evening medication on average reduced the risk of serious sequelae. These include deaths from cardiovascular disease as well as heart attacks, strokes and congestion due to clogged blood vessels. 1752 patients in the study suffered such a severe cardiovascular event. The risk of dying from it was almost half lower in the group taking their medication in the evening.
The blood pressure is subject to regular fluctuations during the course of the day, the so-called circadian rhythm. Especially high values are measured in the mornings and afternoons, while in sleep the blood pressure normally drops below 120 mmHg. First author Ramón Hermida sees this as a reason for incorrect taking time: "The fact that doctors often recommend taking morning medication is based on the misguided goal of lowering morning blood pressure."
However, previous studies have already shown that serious illnesses such as stroke or heart attack are mainly associated with increased nocturnal values. This is what the authors of the study now confirm. "As a result, around-the-clock blood pressure measurements should be recommended to diagnose true arterial hypertension and to assess the risk of such a condition," said Hermida.
The researchers point out that the study was conducted with people who follow a regular day-wake rhythm. Therefore, the results could not yet provide any information about how people should be treated who work in shifts, for example. In general, it is important to clarify the situation for each patient individually.