Loading...
Blood pressure (BP) during sleep predicts cardiovascular (CV) outcomes better than daytime pressure. Peak activity of the renin-angiotensin system is greatest during sleep, and circadian rhythms influence the pharmacokinetics of many BP drugs. Relatively small past studies have suggested BP medications might be most effective if taken at bedtime.
A Spanish team randomized more than 19,000 primary care patients with hypertension to take their medication regimen either at bedtime or on awakening. At baseline, the two groups exhibited similar blood pressure levels and pertinent physiological, comorbidity, and laboratory (e.g., LDL cholesterol) values. Patients were followed rigorously (e.g., repeated 48-hour ambulatory BP measurements at least …