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.
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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