Give BP drugs at night

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INVC,,

Delhi,,

Blood pressure drugs should be taken at night said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India.

Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most attacks of them occur in the early morning hours. Pulse, blood pressure, thickening of platelets all is higher in early morning hours.

Controlling early morning blood pressure can reduce cardio vascular mortality.

According to new research published in October 24 in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure taking at least 1 anti BP drug at bedtime significantly improves blood pressure control, with an associated decrease in risk for cardiovascular events.

The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti BP drugs on awakening or to take at least 1 of them at bedtime.  Patients were followed for a median of 5.4 years; during that time, patients who took at least 1 BP-lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening.

A similar significant reduction in cardiac deaths, heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping.

For each 5-mm-Hg decrease in mean sleep-time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow-up.

Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime, but not morning, treatment.

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