Time of Meds for Nocturnal Hypertension in T2DM Matters

the MPR take:

Previous research has indicated that nighttime blood pressure (BP) is a greater predictor of cardiovascular events vs. daytime BP, so does a change in administration time of antihypertensive drugs benefit patients with type 2 diabetes? 41 patients with type 2 diabetes and nocturnal hypertension (nighttime systolic BP >120mmHg) were randomized in an open-label, crossover study to eight weeks of morning or nighttime administration of all of the patient’s once-daily antihypertensive drugs, followed by eight weeks of switched dosing regimen. Patients taking the drugs at night experienced a significant reduction in nighttime and 24-hour systolic BP (7.5mmHg; P<0.001 and 3.1mmHg; P=0.014, respectively) and a nonsignificant reduction in daytime systolic BP (1.3mmHg; P=0.336). C-reactive protein levels were also significantly lower with nighttime administration. Thus, for patients with type 2 diabetes and nocturnal hypertension, administration of once-daily antihypertensive drugs at bedtime may benefit the patient in treatment of both conditions.

Time of Meds for Nocturnal Hypertension in T2DM Matters
Time of Meds for Nocturnal Hypertension in T2DM Matters

Several studies in different populations have suggested that nighttime blood pressure (BP) is a stronger predictor of cardiovascular events than daytime BP. Patients were randomized to 8 weeks of either morning or bedtime administration of all of the individual's once-daily antihypertensive drugs, followed by 8 weeks of switched dosing regimen.

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