▶ ‘This person’ should be taken in the evening
A study found that there was no significant difference in the effectiveness of high blood pressure medications whether they were taken in the morning or in the evening.
This is contrary to the results of some studies that ‘night blood pressure’, a predictive index for cardiovascular health, decreases when taking high blood pressure medicines in the evening.
According to the results of a large-scale clinical trial (TIME) conducted by a research team led by Professor Thomas MacDonald of Pharmacology and Epidemiology at the University of Dundee, Scotland, 21,104 hypertensive patients (average age 65 years, male 58%, Caucasian 98%) over an average of 5.2 years, hypertension He said that the effect of the drug was similar when taken at any time.
The research team randomly divided the trial participants into two groups: one group (1503) was given antihypertensive medication at night (8-12 PM) and the other group (10,601) in the morning (6-10 AM). ), and the cardiovascular health was followed and observed for an average of 5 years and as long as 9 years.
The research team compared and analyzed whether the incidence of cardiovascular and cerebrovascular diseases, such as non-fatal myocardial infarction or cerebral infarction, hospitalization due to cardiovascular disease, and emergency revascularization, was different between the two groups.
As a result, 362 people (3.4%) in the group taking the antihypertensive drug at night and 390 (3.7%) in the morning group taking the antihypertensive drug showed no significant difference in the occurrence of these cardiovascular and cerebrovascular diseases.
In particular, 13% of trial participants had diabetes, and there was little difference between the evening and morning groups of high blood pressure medication. The incidence of falls and fractures related to taking antihypertensive drugs was not significant in either group.
These results show that the incidence of cardiovascular and cerebrovascular disease is similar no matter what time of day the high blood pressure medication is taken, the research team explained.
However, it may be beneficial to take the antihypertensive drug in the evening for patients with ‘resistant hypertension’ and obstructive sleep apnea, whose hypertension is not well controlled with antihypertensive drugs, the research team added. Regarding the results of this study, Dr. Ryan Tuise, a health researcher at McGill University in Canada, pointed out, “There are patients with ‘nocturnal hypertension’ who have elevated blood pressure at night, but this study did not take these patients into account.”
The research results were presented at the ESC Congress 2022 annual meeting of the European Society of Cardiology (ESC) held in Barcelona, Spain. Previously, Professor Ramon Hermida of the University of Vigo, Spain, presented a study result at the 2019 ESC annual conference that it is better for the body to take antihypertensive drugs at night than during the day.
Professor Hermida found that 19,000 patients with high blood pressure were divided into two randomized groups for comparison and analysis, and found that taking high blood pressure medications while sleeping rather than waking reduced the risk of diseases such as heart attacks and strokes by half.
Half of the patients were asked to take their antihypertensive medication at bedtime and the other half as soon as they woke up, followed by follow-up for 4 to 8 years, measuring blood pressure in an initial 48-hour cycle and at least once a year.
As a result, both groups had similar effects on blood pressure during the daytime. However, the two groups showed significant differences in blood pressure during sleep. Patients who took the drug in the evening had a small but significant decrease in blood pressure during sleep compared to those who took the drug during the day.
When age, sex, smoking status, and history of cardiovascular disease were taken into account, patients who took the drug at night had a 56% lower risk of cardiovascular death, a 49% lower risk of stroke, and a 44% lower risk of heart attack than those who took the drug during the day.
Dae-ik Kwon Medical Specialist reporter>
