Taking blood pressure medication at bedtime is more effective Taking blood pressure medication at bedtime is more effective and may reduce the risk of heart attack and early death. This was the case in the Spanish study, which included about 20,000 adults with high blood pressure (average age 60), half of whom were told to take their blood pressure tablets at bedtime and the other half at waking time. They were followed for an average of six years, during which time about one in 10 experienced a heart attack, heart failure or stroke, or died from cardiovascular disease. The study found that people who took antihypertensive drugs at bedtime had significantly lower blood pressure at night and were 45 percent less likely to have a heart attack and stroke. Unless you take a diuretic, which may mean you have to get up at night to urinate, taking it at night has no negative impact. But before making any changes to the way you use your medication, especially if you are taking several other medications, you may want to talk to the doctor involved first. The study was published in the peer-reviewed EuropeanHeartJournal. They recruited a total of 19,084 patients (mean age 60, 56% male) who were told to take their medication at bedtime or in the morning. Patients were evaluated clinically at least once a year, which included a blood test and wearing a blood pressure monitor for 48 hours (ambulatory blood pressure monitoring). The primary outcome was for patients who experienced one or more of the following: heart attack, stroke, experienced stenting, heart failure, death from cardiovascular disease. Patients taking antihypertensive medication at bedtime had a 45% lower risk of these events. CONCLUSION: Taking antihypertensive medications at bedtime improved blood pressure control and, most importantly, significantly reduced the occurrence of major cardiovascular disease problems. Currently, there is no strict prescribing information on when to take various blood pressure medications during the day, except for diuretics which are often taken in the morning to prevent people from urinating frequently during the night. Despite the positive findings, the trial had some limitations. These include the researchers’ inability to analyze the timing effects of specific blood pressure medications, but further conclusive findings may lead to changes in the prescription of blood pressure medications in the future.