People who take all their blood pressure medications once before bedtime are more able to control their condition and have a "significantly lower risk of death or disease" caused by heart or blood vessel problems compared to those taking antihypertensive drugs in the morning, according to studies published this month in the peer-reviewed European Heart Journal.
The trial instructed 19 084 patients to take their pills on waking or bedtime and following them for more than six years – during which time the ambulatory blood pressure of the patients for 48 hours was checked at least once a year. The results were adjusted for age, gender, type 2 diabetes, kidney disease, smoking and cholesterol levels.
"Morning ingestion is the most common recommendation by physicians."
Researchers found that patients taking their medications before bedtime reduced their risk of death or heart attack, myocardial infarction, stroke, heart failure, or require a procedure to narrow the narrowed arteries, compared to these who take their medicines after waking up in the morning.
The risk of death from heart or blood vessel problems is reduced by 66%, the risk of myocardial infarction is reduced by 44%, coronary revascularization (narrowing of the narrowed arteries) by 40%, heart failure by 42% and stroke by 49%. However, the researchers note that there are no studies showing that treatment for hypertension in the morning reduces the risk of cardiovascular disease.
"Morning ingestion is the most common recommendation of doctors based on a misleading goal – to reduce blood pressure in the morning," said co-author Ramon Hermida, director of the Laboratories of Bioengineering and Chronobiology at the University of Vigo in Spain. Allowing drugs to act before next day's activity can also play a role.
Preventive measures in early adulthood include taking statins – lipid-lowering drugs – and cholesterol-lowering drugs, which may be more effective than simply reading a diet and exercise, especially for those who have a genetic predisposition to high cholesterol and high blood pressure, experts say.
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Between 2008 and 2018 10,614 adult men and 8,470 Caucasian Hispanic women diagnosed with hypertension had to adhere to the routine of daytime activity and nighttime sleep. Hermida said it was not possible to know if the results applied to people working night shifts or those of other racial / ethnic backgrounds.
One possible theory for the results: A bad night's sleep can lead to a rise in blood pressure that night and separate studies are discovered the next day. This study, published in a recent issue of Psychosomatic Medicine, offers an explanation for why sleep problems have been shown to increase the risk of heart attack, stroke, and even death from cardiovascular disease.
Those participants who had lower "sleep" efficacy showed an increase in blood pressure that restless night. They also had higher systolic blood pressure – the number when a person's blood pressure was recorded the next day. According to researchers, good sleep and quality sleep are important for a healthy heart. It also allows medicines to act while the body restores energy.
"Blood pressure is one of the best prognosis for cardiovascular health."
"Blood pressure is one of the best predictions for cardiovascular health," says study lead author Carolyn Doyle, a graduate student in the Department of Psychology at the University of Arizona. Cardiovascular disease is the number one killer in the country. "We wanted to see if we could try to extract some of this story: how sleep can affect illness through blood pressure."
There are other ways to help reduce hypertension. A diet that helps people reduce high blood pressure can also reduce the risk of heart failure in people under 75, according to separate studies recently published in the latest issue of the American Journal of Preventive Medicine.
This "dash" (Dietary Approaches to Stop Hypertension) diet recommends the consumption of fruits, vegetables, nuts, whole grains, poultry, fish and low-fat dairy products while reducing the amount of salt, red meat, sweet and sweetened sugar drinks, whole cream and alcohol in your diet. Apart from the last two products, it is very similar to the Mediterranean diet.