Blood Pressure Pills More Effective When Taken at Night
– New Research Which Shows That Timing Blood Pressure Medication With a
Patient’s Body Clock Make it More Effective and Offers Greater Protection
Against the Occurrence of Heart Attacks and Strokes is Set to Change the
Hypertension Treatment for Hundreds of Millions of People Worldwide
Chronobiology International – the international journal on how biological
rhythms affect the systems of living things – has published the results of a
groundbreaking five-year study that will change the way blood pressure
medication is administered and have a profound impact on the type of
treatment that hypertension patients receive.
In two articles, Chronobiology International covers and interprets the
newly completed MAPEC study, which shows that the simple shift to taking
medication at night instead of in the morning significantly increases
efficacy in keeping blood pressure within a healthy range. In addition,
taking medication at night offers extra protection against heart attacks,
strokes and other types of cardiovascular diseases.
Astonishingly, over the five-year study, the group of patients who took
at least one of their medications at night experienced just one-third of the
number of cardiovascular disease (CVD) episodes experienced by the group of
patients who took all their medications in the morning.
“This study proves that the time of day when patients take their high
blood pressure medications can make a huge difference due to the effect of
the body’s circadian rhythms on the actions of medications and because of the
importance of preserving the normal day-night pattern of blood pressure in
hypertension,” explains the lead investigator of the MAPEC Study Professor
RamÃƒÆ’Ã‚³n C. Hermida, PhD, Director of Bioengineering and Chronobiology Labs at
the University of Vigo in
“Conventional treatment typically advises taking blood pressure
medications in the morning. The MAPEC study shows that conventional treatment
is not the most effective way to help patients with high blood pressure,”
says Professor Hermida.
Taking at least one blood pressure medication at bedtime – as opposed to
taking all medications in the morning – was found, based on around-the-clock
ambulatory blood pressure monitoring, to best normalize the sleep-time blood
pressure. This is known to be the most sensitive predictor of a patient’s
5-year risk of CVD mortality. In addition, the MAPEC study shows that taking
medication at night is the best way to control daytime BP levels.
The study also highlighted the importance of knowing a patient’s
sleep-time blood pressure readings. While most hypertension patients can
attest to the fact that their BP reading is normally taken during a daytime
clinic, not knowing what a patient’s blood pressure is doing over the entire
24-hour period – and crucially, what the sleep-time readings register – is
like playing Russian roulette.
“Historically, medical professionals have operated on the assumption that
sleep-time blood pressure levels will drop by 10-20% from daytime levels.
However, for many patients – called non-dippers – this doesn’t happen and
sleep-time therefore becomes a high risk period,” says Dr
More than 70 million people in the US alone have hypertension. Millions
suffer heart attacks and strokes every year. Imagine if those CVD episodes
could be cut by almost two thirds. Professor Hermida and his team are
convinced there is no time to lose.
“This study was the first to conclusively find that the time of day when
medications are ingested not only affects efficacy but also CVD risk and
these findings must fundamentally change the way patients are treated
worldwide,” continues Dr Portaluppi.
Dr Hermida, Dr Portaluppi and the team of experts who analysed the study
results conclude that a number of steps should be taken urgently in order to
best utilise the findings and save lives.
First, 24-hour ambulatory blood pressure monitoring should be the proper
means of differentiating the needs of BP patients and the only means of
categorising patients as non-dippers in the 24-hour pattern. It is also the
best means of confirming that treatment goals of BP control are met, which
include ensuring that sleep-time BP levels are in the correct range.
Second, elevated sleep-time blood pressure should be made an important
new therapeutic clinical target for medications. Based on this and borne out
by the results of the study, prescribing that hypertension medications be
taken at night offers an inexpensive and highly efficacious means of
controlling blood pressure without the need to increase either the dose or
number of medications.
“Our body clocks are extremely powerful biological tools and this study
offers insight and hard facts on how we can harness that power to help
millions of people stay healthier and safer by ensuring that their blood
pressure medications are taken as effectively as possible,” Dr
Influence of Circadian Time of Hypertension Treatment on Cardiovascular
Risk: Results of the MAPEC Study was written by: RamÃƒÆ’Ã‚³n C. Hermida,
Perspectives on the Chronotherapy of Hypertension Based on the Results of
the MAPEC Study was written by:
For access to these articles, please click on the links above.
SOURCE Chronobiology International