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Which time is better to take a medication?



Major studies said that taking blood pressure medication at bedtime rather than daytime will lower the risk of heart attack and stroke.

The University of Vigo in Spain, Prof Ramon Hermida, first author of the study said the effect was through to body’s internal clock that means processes and chemicals within our bodies vary over 24 hours, different effects if taken at a different point in time or something called chronotherapy.

“The same antihypertensive medication, the same molecule, at the same dose, ingested at two different times have different pharmacokinetics and pharmacodynamics and therefore they behave as two different medications,” said Hermida.

There have also been studies suggesting blood pressure medications are more effective when taken in the evening and might result in fewer heart attacks and strokes.

After a test conducted to a group of people taking the medication day and night separately.
The impact on daytime blood pressure was similar, those taking their medication at bedtime had a small but significantly greater reduction in blood pressure during sleep compared with those taking medication on waking, as well as a greater difference in blood pressure when sleeping compared with being awake.

Prof. Hermida explains that the hormone system that regulates blood pressure peaks inactivity during sleep, meaning it might be that medications interact with this system has a greater effect when taken just before bed.

After taking into account factors such as age, sex, smoking status, history of cardiovascular events and typical decrease in blood pressure when asleep, the team found patients who took their medication at bedtime had a 56 percent lower risk of death from cardiovascular disease, a 49 percent lower risk of stroke and a 44 percent lower risk of heart attack compared with the other group.

The findings need to be confirmed in a more diverse range of ethnicities, while it is not clear if they would hold among those undertaking shift work.



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