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Taking blood pressure meds at night
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<blockquote data-quote="BigTex" data-source="post: 227331" data-attributes="member: 43589"><p>Thanks Vince!</p><p></p><p>I remember my cardiologist telling me it didn't matter since most have a very long half life. But I disagreed and show my my records taking BP meds in the morning or at night. Part of why he got fired. So I will add to your post.</p><p></p><p>Ramón C Hermida, Juan J Crespo, Manuel Domínguez-Sardiña, Alfonso Otero, Ana Moyá, María T Ríos, Elvira Sineiro, María C Castiñeira, Pedro A Callejas, Lorenzo Pousa, José L Salgado, Carmen Durán, Juan J Sánchez, José R Fernández, Artemio Mojón, Diana E Ayala, for the Hygia Project Investigators<strong>, Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial,</strong> <em>European Heart Journal</em>, Volume 41, Issue 48, 21 December 2020, Pages 4565–4576, <a href="https://doi.org/10.1093/eurheartj/ehz754" target="_blank">Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial</a></p><p></p><h2>Abstract</h2><p><strong>Aims</strong></p><p>The Hygia Chronotherapy Trial, conducted within the clinical primary care setting, was designed to test whether bedtime in comparison to usual upon awakening hypertension therapy exerts better cardiovascular disease (CVD) risk reduction.</p><p></p><p><strong>Methods and results</strong></p><p>In this multicentre, controlled, prospective endpoint trial, 19 084 hypertensive patients (10 614 men/8470 women, 60.5 ± 13.7 years of age) were assigned (1:1) to ingest the entire daily dose of ≥1 hypertension medications at bedtime (<em>n</em> = 9552) or all of them upon awakening (<em>n</em> = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared with the upon-waking, treatment-time regimen showed significantly lower hazard ratio—adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event—of the primary CVD outcome [0.55 (95% CI 0.50–0.61), <em>P</em> < 0.001] and each of its single components (<em>P</em> < 0.001 in all cases), i.e. CVD death [0.44 (0.34–0.56)], myocardial infarction [0.66 (0.52–0.84)], coronary revascularization [0.60 (0.47–0.75)], heart failure [0.58 (0.49–0.70)], and stroke [0.51 (0.41–0.63)].</p><p></p><p><strong>Conclusion</strong></p><p>Routine ingestion by hypertensive patients of ≥1 prescribed BP-lowering medications at bedtime, as opposed to upon waking, results in improved ABP control (significantly enhanced decrease in asleep BP and increased sleep-time relative BP decline, i.e. BP dipping) and, most importantly, markedly diminished occurrence of major CVD events.</p></blockquote><p></p>
[QUOTE="BigTex, post: 227331, member: 43589"] Thanks Vince! I remember my cardiologist telling me it didn't matter since most have a very long half life. But I disagreed and show my my records taking BP meds in the morning or at night. Part of why he got fired. So I will add to your post. Ramón C Hermida, Juan J Crespo, Manuel Domínguez-Sardiña, Alfonso Otero, Ana Moyá, María T Ríos, Elvira Sineiro, María C Castiñeira, Pedro A Callejas, Lorenzo Pousa, José L Salgado, Carmen Durán, Juan J Sánchez, José R Fernández, Artemio Mojón, Diana E Ayala, for the Hygia Project Investigators[B], Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial,[/B] [I]European Heart Journal[/I], Volume 41, Issue 48, 21 December 2020, Pages 4565–4576, [URL="https://doi.org/10.1093/eurheartj/ehz754"]Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial[/URL] [HEADING=1]Abstract[/HEADING] [B]Aims[/B] The Hygia Chronotherapy Trial, conducted within the clinical primary care setting, was designed to test whether bedtime in comparison to usual upon awakening hypertension therapy exerts better cardiovascular disease (CVD) risk reduction. [B]Methods and results[/B] In this multicentre, controlled, prospective endpoint trial, 19 084 hypertensive patients (10 614 men/8470 women, 60.5 ± 13.7 years of age) were assigned (1:1) to ingest the entire daily dose of ≥1 hypertension medications at bedtime ([I]n[/I] = 9552) or all of them upon awakening ([I]n[/I] = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared with the upon-waking, treatment-time regimen showed significantly lower hazard ratio—adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event—of the primary CVD outcome [0.55 (95% CI 0.50–0.61), [I]P[/I] < 0.001] and each of its single components ([I]P[/I] < 0.001 in all cases), i.e. CVD death [0.44 (0.34–0.56)], myocardial infarction [0.66 (0.52–0.84)], coronary revascularization [0.60 (0.47–0.75)], heart failure [0.58 (0.49–0.70)], and stroke [0.51 (0.41–0.63)]. [B]Conclusion[/B] Routine ingestion by hypertensive patients of ≥1 prescribed BP-lowering medications at bedtime, as opposed to upon waking, results in improved ABP control (significantly enhanced decrease in asleep BP and increased sleep-time relative BP decline, i.e. BP dipping) and, most importantly, markedly diminished occurrence of major CVD events. [/QUOTE]
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Taking blood pressure meds at night
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