Medication at Bedtime Gives Better BP Control in Diabetes
Bedtime medication lowers blood pressure and cardiovascular risk better than morning medication
MONDAY, June 20 (HealthDay News) -- In patients with diabetes, taking one or more hypertension medications at bedtime gives better blood pressure control and major cardiovascular event risk reduction compared to morning medication, according to a study published in the June issue of Diabetes Care.
Ramón C. Hermida, Ph.D., from the University of Vigo in Spain, and colleagues investigated whether taking one or more hypertension medications at bedtime exerted better blood pressure control and cardiovascular risk reduction than taking all the medications in the mornings. The study included 448 patients, with an average age of 62.5 years, with hypertension and type 2 diabetes. Participants were randomly assigned to take their medications when they awoke, or to take one or more at bedtime. Ambulatory blood pressure was recorded for 48 hours at baseline, and annually or quarterly after adjustments in treatment for an average of 5.4 years.
The investigators found that, after adjusting for age and sex, participants taking medications at bedtime had a significantly lower cardiovascular risk than those taking medications in the mornings (hazard ratio [HR], 0.33). The two groups showed a statistically significant difference in the adjusted risk of cardiovascular death, myocardial infarction, and stroke (HR, 0.25). Significantly lower mean sleep time blood pressure and increased prevalence of controlled ambulatory blood pressure was seen in patients treated at bedtime. Each 5 mm Hg decrease in asleep systolic blood pressure was associated with a significant 12 percent decrease in cardiovascular risk.
"Among patients with diabetes, treatment with ≥1 hypertension medications at bedtime, compared with all medications upon waking, resulted in improved ambulatory blood pressure control and significantly reduced cardiovascular morbidity and mortality," the authors write.