Bedtime Blood Pressure Medication Saves Lives

by Dr Dan Ewald, Lead Clinical Adviser, NCPHN

Who’d have thought it was so important what time of day someone takes their medication for high blood pressure?

This study will change my practice.

This Spanish study of 19,084 people with hypertension, confirmed by ambulatory blood pressure (BP) monitoring, needing >1 type of medication, were randomised to receive their daily antihypertensive meds all at night versus all in the morning. Participants were followed for a mean of 6.3 years in primary care settings. 1,752 participants experienced a cardiovascular event. After correcting for risk factors, the bedtime group had about half the risk of a cardiovascular disease (CVD) event. The results were consistent across a wide range of types of CVD events, including mortality.

Night time dipping in BP has been recognised as an important risk marker for CVD outcomes. This is the first trial to test the impact of night dosing on CVD events, and the impact is impressive!

I am sure this study will attract a lot of attention, and should change our prescribing practices.