By Elizabeth Saenger, PhD

A huge Spanish study found that subjects who took their hypertension drugs at bedtime (vs in the morning) had no change in their blood pressure during the day. However, they improved their blood pressure at night. More importantly, they significantly decreased their risk of major cardiovascular events, such as heart failure and stroke.

The interpretation of these results is controversial. In part, this is because the decrease in blood pressure at night, for the people who took medication at bedtime, was small. However, the investigators felt that progressive decreases in nighttime blood pressure might have predictive value. Specifically, the researchers thought these decreases might be more useful for predicting cardiovascular events than the risk factors traditionally used, such as advanced age, gender, low HDL (good) cholesterol, and smoking.

Consequently, both the researchers who led the study, and their critics, look forward to seeing more data on how the time patients take hypertension medication might influence its effects.

The Original Study

Hermida RC, Crespo JJ, Dominguez-Sardina M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J. 2019;Epub ahead of print.

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