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Paper Chase #1 - Hypertension Treatment at Bedtime

Tom Robertson, MD and Steve Biederman, MD
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Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial

 

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Ian L., Dr -

Splitting the dosing eg Calcium Channel Blockers at night and Diuretic -ACE or Angiotensin Receptor Blocker -Diuretic on th morning was not tested.
Would taking a thiazide Diuretic at night lead to nocturia ?

Neda F., MD -

Hi Ian. It absolutely could. Most patients prefer to take thiazides in the morning for that exact reason. Take care -- Neda

Stephen L., 7886654 -

I came upon an interesting study in the American Journal of Hypertension that showed that "Bedtime in comparison to awakening-time ingestion of nifedipine was also associated with a reduction in the incidence of edema from 13 to 1% (P < 0.001)." I started to tell my patients to take their CCB at night to possibly decrease their risk of getting leg swelling. See the link below. Cheers!

https://www.ncbi.nlm.nih.gov/pubmed/18600215

Hermida RC, Ayala DE, Mojón A, Fernández JR. Chronotherapy with nifedipine GITS in hypertensive patients: improved efficacy and safety with bedtime dosing. Am J Hypertens. 2008;21:948–954.

Neda F., MD -

What a great pearl, and thank you for sharing that article! Fascinating stuff. Thanks for writing, Stephen! -- Neda

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Hippo Primary Care RAP Written Summary February 2020 764 KB - PDF

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