Taking antihypertensives at bedtime could reduce blood pressure during sleep and also cut the risk of developing type 2 diabetes by half, compared to taking it in the morning. Findings from the two papers are published in the journal Diabetologia.
The first paper described that lowering blood pressure during sleeping hours may be a potential target for intervention to prevent new onset of diabetes. The second paper studied whether therapy with the entire daily dose of one more antihypertensives at bedtime showed greater reduction in the risk of new-onset diabetes than therapy with all antihypertensives upon awakening.
Researchers from University of Vigo, Spain, conducted a prospective, randomized, open-label, blinded endpoint trial (n=2,012) of hypertensive patients without diabetes. They were randomized to either take all their prescribed therapies upon awakening or the entire daily of one more of them at bedtime.
A total of 171 study patients developed type 2 diabetes. Those in the bedtime-treatment group demonstrated a significantly lower mean blood pressure while sleeping and a greater a sleep-time relative blood pressure decline, as compared with the morning-treatment group. The bedtime-treatment group also showed a lower incidence of ‘non-dipping’ (32% vs. 52%), where the patient’s nighttime blood pressure falls by <10% compared to daytime blood pressure.
Researchers saw a 57% reduced risk of type 2 diabetes in the bedtime-treatment group after adjusting for potential confounding factors such as fasting glucose, waist circumference, mean asleep systolic blood pressure, dipping classification, and chronic kidney disease. Specifically, treatment with angiotensin receptor blockers (ARBs), ACE inhibitors, and beta blockers led to greater reduction in risk of developing diabetes for the bedtime-treatment group vs. the morning-treatment group (61%, 69%, 65%, respectively).
Taking an antihypertensive regimen at bedtime is as safe as taking them upon awakening, researchers concluded. Significantly improved sleeping blood pressure control and prevention of new-onset was seen in hypertensive patients who took the entire daily dose of one or more antihypertensives at bedtime vs. upon awakening.
For more information visit Diabetologia-Journal.org.