The Best Time To Take Blood Pressure Drugs

People with high blood pressure could halve the risk of developing type 2 diabetes by taking hypertensionmedication at bedtime rather than in the morning, new research finds.

The trial included 2,012 patients with hypertension without diabetes. In the second paper, they investigated whether therapy with the entire daily dose of one or more hypertension (high blood pressure) medications at bedtime exerts greater reduction in the risk of new-onset diabetes than therapy with all medications upon awakening.

During follow-up, 171 participants developed type 2 diabetes; 4.8% of cases in the bedtime group and 12.1% in the morning group. They were randomly assigned to take all their blood pressure medications either first thing in the morning or right before bed.

Ramón C. Hermida, Ph.D., from the University of Vigo in Spain, and colleagues examined the prognostic value of clinic and ABP to predict new-onset diabetes in a cohort of 2,656 individuals without diabetes.

In a second trial, the researchers observed that patients who medicated at night were 57 per cent less likely to develop type 2 diabetes. Patients’ blood pressure was monitored for 48-hour periods at least once a year-or more frequently if medication was adjusted-to accurately gauge blood pressure during the day and at night. Systolic pressure is the top number in a blood pressure reading. Angiotensin also contributes to increased glucose (sugar) release from the liver and decreased insulin sensitivity. Researchers followed the cohort for a mean of 5.9 years.

The first paper described that lowering blood pressure during sleeping hours may be a potential target for intervention to prevent new onset of diabetes.

Earlier studies have failed to show any type 2 diabetes prevention benefit from blood pressure medications, but they may have been flawed because people were asked to take the drugs in the morning, Bloomgarden said.

The studies, which come from the same research team at the University of Vigo in Spain, appear in Diabetologia, the official journal of the European Association for the Study of Diabetes.

“I would absolutely consider” suggesting a patient switch to taking medications at night, said Dr. Freeby, an assistant professor of endocrinology, diabetes and hypertension at the David Geffen School of Medicine. The bedtime-treatment group also showed a lower incidence of “non-dipping” (32% vs. 52%), where the patient’s nighttime blood pressure falls by 10% compared to daytime blood pressure. The importance of blood pressure at night.