A new randomized clinical study in China shows that the administration of a blood pressure pill once a day, before bedtime, reduced the night blood pressure more than its administration after waking up.
The study was conducted on 720 adults. Photo archive Pexels
The result was maintained for a period of 12 weeks, without raising safety issues, according to Earth.com.
The study, published in the Jama Network Open, was led by Xiaoping Chen, MD, West China Hospital, Sichuan University (Wchscu).
The researchers compared the administration in the morning between 6:00 and 10:00 with the administration before bed between 18:00 and 22:00.
They recruited 720 adults from 15 hospitals and used a single combination of Olmesartan 20 mg pills with 5 mg amlodipine. They adjusted the dose at 4 and 8 weeks, using outpatient measurements in the cabinet.
After 12 weeks, bedtime administration reduced the nighttime systolic pressure by 3.0 mm Hg more than the administration in the morning and also reduced the nocturnal diastolic pressure.
The nocturnal systolic control reached 79.0% with the administration at bedtime, compared to 69.8% with the administration in the morning.
At the cabinet, the systolic control was 88.7% for dosing before bedtime and 82.2% for dosing in the morning. The rates of nocturnal hypotension and the general side effects were similar between groups.
Synchronization can be useful
Chronotherapy, that is, synchronizing the time of administration of medicines with the biological clock to improve the results – can be useful. The idea is simple: the maximum action of the drug must be aligned with the hours when the tension tends to behave unusually.
Amlodipine reaches maximum levels at 6-12 hours after administration and has a long half-life. The official label of the FDA documents this temporal profile, which fits well with the administration of the tablet in the evening, to influence the night period.
Olmesartan blocks the renin-angiotensin system, which can increase when renal blood flow decreases during sleep.
According to the researchers, combining it with amlodipine in a single tablet can ensure stable night control, without losing daily coverage.
The study team also used ambulatory blood pressure monitoring (ABPM) to adjust the therapy, which records values every 20-30 minutes, during the day and night, an approach that facilitates the detection of persistent nocturnal tension, which can be omitted in clinical controls.
“A practical lever”
When nocturnal blood pressure (average values measured during sleep) is high, synchronization can be a practical lever. The study showed a better nocturnal control and fewer dose increases when people took the pill.
Clinical guides are already encouraging simple plans, in which patients can adhere.
Global hypertension guides recommend that many adults begin treatment with a single combination of tablets, which can reduce the number of tablets and help maintain a constant routine.
However, a collaboration with the doctor is needed to choose a moment that suits the personal rhythm of each patient and his lifestyle.
Do not change the time of drug administration alone if you have conditions such as diabetes with autonomous neuropathy, advanced renal disease or a history of fainting, draw the attention of the specialists.
It’s about “potential” advantages
The new results are short -term and focus on blood pressure behavior, not heart attacks or strokes. Longer studies that follow the events will show whether a few millimeters drop at night translates into a smaller number of emergencies.
The researchers reported greater benefits at night among older adults and other groups, but these signals should be confirmed before giving general advice.
“These discoveries support the potential advantages of bed administration”says Chen. This is a cautious statement, which fits the data and prepares the land for the next round of research.
