Antihypertensive drug in the morning or in the evening? New perspectives
A few years ago, a study concluded that in the evening revenue of blood pressure medication is better than the morning one. Now presented the results of scientific investigations contradict but the knowledge of the time.
According to a study presented at the Scientific Congress of the European Society of Cardiology (ESC) in Barcelona, taking blood pressure medication in the evening is no better than taking it in the morning, the ESC reports in a press release. Message.
The time of ingestion has no influence
A pragmatic randomized study of more than 21,000 hypertensive patients followed for five years concluded that protection against heart attacks, strokes and vascular death is not affected by taking antihypertensive drugs in the morning or evening.
Research contradicts previous findings studysuggesting a very large cardiovascular benefit from nocturnal administration.
Most common cause of premature death
More than a billion people worldwide suffer from high blood pressure. Hypertension is the most common cause of premature death and, according to the ESC, caused nearly ten million deaths in 2015, of which 4.9 million were due to ischemic heart disease and 3.5 million to strokes.
Nighttime blood pressure is a better predictor of cardiovascular outcomes than daytime blood pressure, and an older reported in the journal”hypertension‘, provided evidence that antihypertensive drugs taken in the evening rather than in the morning had greater reductions in nocturnal blood pressure.
In the review “Journal of Human HypertensionHowever, previously published studies have been criticized, indicating that the results should be interpreted with caution and that stronger evidence is needed before changing clinical practice.
Clear results
“TIME” was a large, prospective, randomized study conducted to test whether taking antihypertensive drugs in the evening improved key cardiovascular outcomes compared to taking them in the morning.
A total of 21,104 people were randomised, with 10,503 taking the drug in the evening and 10,601 in the morning. The average age of participants was 65, 58 percent were male. The median follow-up was 5.2 years. The results are published in the journalBMJ open“.
“TIME was one of the largest cardiovascular trials ever conducted and offers a final answer to the question of whether antihypertensives should be taken in the morning or in the evening”said study leader Professor Thomas MacDonald, from the University of Dundee, UK.
“The study clearly revealed that heart attacks, strokes and vascular death occurred at similar rates regardless of when they were given. People with high blood pressure should take their usual antihypertensive drugs at the same time time of the day take what suits them and minimizes side effects. (ad)
Author and source information
This text corresponds to the requirements of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.
Sources:
European Society of Cardiology: Evening dosing of blood pressure medications no better than morning dosing, (accessed August 27, 2022), European Society of Cardiology
Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al. : Treatment of hypertension at bedtime improves cardiovascular risk reduction: the Hygia Chronotherapy trial; in: European Heart Journal, (published: 21.12.2020), European journal of the heart
Hermida RC, Ayala DE: Chronotherapy with ramipril, an angiotensin-converting enzyme inhibitor, in essential hypertension: improved blood pressure control when taken at bedtime; in: Hypertension, (published: 05/11/2009), hypertension
Ho CLB, Chowdhury EK, Doust J, et al. : The effect of taking antihypertensive drugs at night on the risk of cardiovascular disease. A systematic review; in: Journal of Human Hypertension, (published on: 01/18/2021), Journal of Human Hypertension
Rorie DA, Rogers A, Mackenzie IS, et al. : Methods of a large prospective, randomized, open-label, blinded study comparing morning versus evening administration in hypertensive patients: the Treatment In Morning versus Evening (TIME) study; in: BMJ Open, (published: 2016-02-09), BMJ open
Important note: This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.