April 01, 2020

Blood pressure drugs at bedtime: Lower heart risks?

It's been said that timing is everything, and a new study from Spain indicates that this also applies to taking your blood pressure medications.

The study involved more than 19,000 mostly older adults who were taking one or more blood pressure medications. Half were instructed to take the medication just before going to sleep. The other half were instructed to take their usual blood pressure drugs first thing in the morning. After about six years of follow-up, those taking blood pressure drugs before bed had a 66% lower risk of dying of cardiovascular disease, a 34% lower risk of heart attack, a 42% lower risk of developing heart failure and a 49% lower risk of stroke, as compared with those taking blood pressure drugs in the morning. There were no observed safety differences between dosing times.

Mayo Clinic experts say that current guidelines for taking blood pressure drugs in the United States don't reflect this recent research, and it may take time and additional research before a guideline change is considered.

Should you make the switch anyway? It's worth discussing with your doctor or pharmacist. There's the potential for more frequent nighttime urination when taking stronger, faster acting diuretic drugs such as furosemide (Lasix). Otherwise, there appears to be little if any downside to bedtime dosing, and the upside could be substantial.