Bedtime May Be Best Time for Blood Pressure Meds

Taking blood pressure medications at bedtime rather than in the morning nearly halves the risk of dying from a heart attack, stroke or heart failure, a large, new study finds.

Researchers in Spain followed more than 19,000 adults with high blood pressure. They found that people who took all their blood pressure meds at night had lower blood pressure around the clock compared to volunteers who took their medication in the morning.

"The findings are highly consistent regardless of sex, age, presence of diabetes or kidney disease, and other major known factors of increased risk" said study lead author. Conventionally, most patients ingest their medication in the morning, although no single trial ever documented this to be preferable. No guidelines are currently in place regarding the best time to take the drugs.”

A New York City heart specialist believes consistency in taking your blood pressure pills will deliver optimal protection. "The key here is routines and not missing a dose. We know one thing worse than an elevated blood pressure is swings in blood pressure due to periodic non-compliance." Besides compliance, factors such as emotions and simultaneous use of other medications can affect a drug's effectiveness.

The investigators found that those who always took their meds at night saw their risk of dying as a result of heart or blood vessel problems plunge by two-thirds, compared with those who always took them in the morning. A bedtime drug regimen was also linked to a 44% drop in heart attack risk; a 40% drop in the risk for surgery to widen arterial pathways (coronary revascularization); a 42% lower risk for heart failure; and a 49% dip in stroke risk, the researchers reported. Overall, the reduction in risk for cardiovascular-related death was 45%, the findings showed.

The yearly 48-hour mobile blood pressure readings showed that patients who took their meds at night had "significantly reduced" blood pressure while asleep, compared with their peers who followed a morning medication routine.

Patients should speak with their doctor before changing the timing of their medication.

The study results were published online Oct. 22 in the European Heart Journal.