2024-09-17 00:38:55
The time that a patient with high blood pressure takes his medication does not affect the risk of cardiovascular events, which is important in taking antihypertensive medication in compliance.
A new study and meta-analysis presented at the European Society of Cardiology Congress (ESC 2024), held in London in September, puts an end to the debate on the best time to take pharmacological treatment for high blood pressure (HTN ).
The conviction that taking antihypertensive drugs before going to sleep arose from a study by a group at the University of Vigo, whose conclusions were published in 2019. The study Sanitation showed a reduction in deaths, heart attacks and strokes of more than 40% among patients with HTN who received treatment at night, compared to those who took it in the morning, Manuel Anguita, spokesperson for the Social Society of The heart of Spain. “The work caused a lot of interest around the world, with some doubts about the technique used and the question about whether it can be repeated.”
Now, two years ago, also in the European Parliament, the data from the study was presented FIRSTA British study found no difference in cardiovascular (CV) events in relation to duration of antihypertensive medication.
And in this last meeting is known “the study of the tiebreaker”, as Manuel Anguita refers to this medium. These days, performance data is presented BedMed which analyzed the chronological hypothesis in two very different scenarios: in patients with a median age of 67 years (56% were women) and in another group with a median age of 88 years (72% women). The conclusion, again, is that the time you take the drug has no effect.
‘When you don’t forget’
In fact, in a meta-analysis, also presented at ESC 2024, with the aforementioned studies (more than 46,000 patients in total) it was also concluded that there is no difference.
The lead director of the study, Scott Garrison, from the University of Alberta, in Edmonton (Canada), pointed out that “the administration at bedtime instead of in the morning did not provide differences in the important events of the cardiovascular system, or in the hypotensive possibility, view , knowledge or other events related to safety, neither in the general population nor, more importantly, in frail elderly patients, a group that is often excluded from clinical trials. “We can now do manage treatment time as necessary and advise patients to take their blood pressure medication when they are least likely to forget.” Drugs with circadian rhythms
This is also emphasized by the psychologist Manuel Anguita who shows the importance of drug adherence over other considerations; “It is best for the patient to decide what is the best time of day to take the treatment.”
The meeting has also welcomed the new clinical guidelines on HTA, which, broadly speaking, continue with the recommendations of the previous ones, the SEC spokesperson told this medium.
The concept of BP ‘standard-promotion’ in the new guidelines
“The most remarkable thing that we can see is that, following the tradition of the American guidelines, the category of high blood pressure (BP) is established, without reaching HTN, in numbers ranging from 120 -139 / 70-89 mm Hg.
The guidelines maintain the definition of HTN in BP ≥140/90 mm Hg, so Manuel Anguita notes that there will not be significant differences for the purposes of drug management of patients. However, this new category normal high BP targeting patients at risk of developing HTN, with the aim of reducing CV events.
“It has also been determined to which values are recommended to reduce BP, something that must be considered especially in elderly patients and in coronary patients. In the light of new studies, the guidelines decide that it is safe for desired BP levels to be 120/7, if the patient tolerates well.” Sonia Moreno (DM)
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