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Lowering blood pressure before going to bed can reduce cardiovascular risks
A study by Spanish researchers has shown that high blood pressure levels at night increase the risk of cardiovascular diseases even more than the same values during the day. This risk can be significantly reduced by taking antihypertensives before bed.
Risk factor for dangerous cardiovascular diseases
Hypertension is considered a widespread disease, especially in the western world. According to the German Hypertension League (DHL), around 20 to 30 million people are affected in this country. Too high blood pressure is a significant risk factor for dangerous cardiovascular diseases such as heart attack and stroke. To lower blood pressure, it is often enough to eat healthier and exercise more. But in some patients, hypertension must be treated with medication. Researchers are now reporting that taking antihypertensives before bed can more effectively reduce cardiovascular risk.
Measure blood pressure while sleeping
Even though hundreds of millions of people with high blood pressure live worldwide, very few people know what their blood pressure values are like during sleep.
In some patients, however, blood pressure measurements are taken during the nightly break during 24 or 48-hour measurements with outpatient systems.
Spanish scientists have now also done this in a study with over 18,000 participants and found that nocturnal hypertension is particularly dangerous.
Data from over 18,000 people evaluated
For the study, which was published in the European Heart Journal, the researchers led by Ramón Hermida from the University of Vigo (Spain) evaluated data from 18,078 people.
15,674 of the subjects suffered from hypertension. Almost two thirds of these patients (9,709 people) had not previously been treated for high blood pressure.
As part of the study, the blood pressure of these participants was lowered with medication. The subjects were divided into two groups.
One group took the blood pressure lowerers only during the day, the other should take at least one preparation in the evening shortly before going to bed.
Blood pressure was measured several times in all patients at the start of the study and in all follow-up visits that took place at least once a year.
Furthermore, the course of the blood pressure was recorded by all subjects after each consultation with an outpatient blood pressure measurement system over a period of 48 hours. This took a measurement every 20-30 minutes.
In addition, all cardiovascular events were documented during the study period.
Increased risk of high blood pressure at night
According to the scientists, a cardiovascular event occurred in 2,311 people (12.8 percent of the participants) during the study period (the median observation period was five years).
In 1,209 cases, the event had serious consequences such as cardiac death, heart failure, heart attack, heart failure or stroke.
The serious events particularly affected older male patients who had multiple illnesses.
As expected, there was also a clear correlation between the occurrence of a cardiovascular event and increased systolic blood pressure.
Patients who had a systolic blood pressure of ≥ 135 mmHg at the initial examination had a 34 percent increased risk of a cardiovascular event.
In subjects with nightly systolic blood pressure> 120 mmHg, the risk increased by as much as 62 percent.
Study participants without cardiovascular problems, on the other hand, had a systolic blood pressure during sleep that was about 9 mmHg lower on average than patients who had cardiovascular events.
Take blood pressure lowering in the evening if necessary
The study confirmed that hypertension during sleep is associated with a significantly increased risk of cardiovascular events.
It was also shown that taking an antihypertensive medication in the evening could reduce this risk for patients by more than half.
The authors therefore recommend that blood pressure values be determined during sleep in hypertensive patients, for example over 48 or 24 hour blood pressure measurements.
If an increased blood pressure is found at night, at least one blood pressure lowering should only be taken in the evening. (ad)