A study by Spanish researchers published Oct. 22 in the European Heart Journal strongly suggests that blood pressure  medication taken at night reduces cardiovascular risk more than meds taken in the morning. Some 19,000 hypertensive patients (men and women, average age 60) were assigned to take their blood pressure pills at bedtime  or upon awakening. Over 6.3 years, 1,752 participants experienced a serous cardiovascular event (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke) and there 1,494 other registered events (including angina pectoris, peripheral artery disease, retinal artery thrombotic occlusion, and transient ischemic attack).

Those who took their meds at bedtime were 43 percent less likely to experience a cardiovascular event! Also, the researchers reported, “The bedtime therapeutic strategy was also associated with improved renal function and favorable redistribution of lipid profile —significantly lower LDL cholesterol and higher HDL cholesterol.” 

Dr. Joe D. Goldstrich comments, “Good study. There was a similar study a few years ago showing the same results. I think the reason for the benefit is that normally with sleep there is a drop in the blood pressure and taking the medicine before bedtime enhances this drop. Of course, it assumes that you have decent sleep to derive all the benefits.”

It was jarring to read in the study’s “Inclusion and Exclusion Criteria” that participants in the trial “represented a population of Caucasian Spanish men and women.” Do men and women of Asian and African descent respond differently to blood pressure mefications? —Fred Gardner