High Blood Pressure On The Rise At Night Time

High Blood Pressure On The Rise At Nighttime

Research from Sichuan University in China has shown that taking antihypertensive medication at bedtime improves nighttime high blood pressure control compared to taking it in the morning for patients with hypertension.

Hypertension is a major health issue worldwide. In China, nearly 300 million people have high blood pressure, and less than 17% manage to control it effectively. Nighttime high blood pressure is often harder to manage and can be a better indicator of heart attack and stroke risk than daytime levels.

Earlier studies have looked into the best timing for antihypertensive medication, but they produced mixed results and varied outcomes.

In the study, “Morning vs. Bedtime Dosing and Nocturnal Blood Pressure Reduction in Patients With Hypertension: The OMAN Randomized Clinical Trial,” published in JAMA Network Open, researchers carried out a randomized clinical trial. They compared the effects of taking antihypertensive drugs at bedtime versus in the morning on lowering nocturnal blood pressure and controlling circadian rhythms. In a trial across 15 hospitals in China, 720 participants aged 18 to 75 took part. They either had never received treatment for hypertension or had stopped their treatment for at least two weeks.

Participants were randomly divided into groups that received antihypertensive medication either in the morning (6:00 to 10:00 AM) or at bedtime (6:00 to 10:00 PM). All patients took a single pill that combined olmesartan (20 mg) and amlodipine (5 mg). Dosage adjustments were made every four weeks based on readings from ambulatory and office hypertension monitoring.

After 12 weeks, the bedtime dosing group experienced a larger drop in nighttime systolic blood pressure, with a difference of -3.0 mmHg (95% CI, -5.1 to -1.0 mmHg) compared to the morning dosing group. Nighttime diastolic hypertension also decreased more in the bedtime dosing group, with a decrease of -1.4 mmHg (95% CI, -2.8 to -0.1 mmHg).

The rates of nighttime systolic blood pressure control were higher in the bedtime dosing group at 79.0%, while the morning dosing group reported 69.8%. In the office, the systolic hypertension control rates were 88.7% for the bedtime group and 82.2% for the morning group.

Bedtime dosing also reduced morning systolic and diastolic blood pressure with fewer increases in dose. There were no significant differences in the rates of nocturnal hypotension or reported side effects between the two groups.

Researchers concluded that bedtime dosing offered better control of nighttime hypertension and improved circadian rhythm without affecting the effectiveness of daytime or 24-hour blood pressure. It also did not increase the risk of nocturnal hypotension.

These findings highlight the possible benefits of taking medication at bedtime and provide evidence that can inform future studies on antihypertensive treatment timing.

We are now buying machines for people with both diabetes and hypertension who can’t afford to purchase and check their sugar levels and pressure because of a lack of funds. We want to make sure that people have an idea of their readings, as both blood pressure and diabetes can cause damage to the kidney, heart, eyes, nerves, and arteries.

Complications from diabetes are killing our young people, and so is stroke from clogged arteries and hypertension. As a people, we must muster some form of resources to help the poor and the elderly, as all of us will become elderly.

Source: Patrice Delves