Hypertensive patients who are prescribed blood pressure lowering medications at bedtime have better controlled blood pressure and a significantly diminished occurrence of cardiovascular (CV) events than those who take their medication in the morning, according to new findings from the Hygia Chronotherapy Trial.
The multicentre trial is the largest to investigate the effect of the time of day when people take their anti-hypertensive medication on their risk of cardiovascular disease (CVD). It recruited 19,084 hypertensive patients who were randomised to take the entire daily dose of ≥1 hypertension medications at bedtime (n=9,552) or all of them upon awakening (n=9,532). Participants were followed for an average of six years, during which time ambulatory blood pressure (ABP) was checked over 48 hours at least once a year.
The study found patients in the bedtime treatment group not only had better ABP control but also had a significantly lower risk of the primary CV outcome (CVD death, myocardial infarction, coronary revascularisation, heart failure or stroke) compared with those ingesting all medications upon wakening (hazard ratio [HR] 0.55; 95% CI 0.50-0.61; P<.001>
The findings are published in the European Heart Journal.