A recent study has revealed a link between timing blood pressure medication with an individual's chronotype and a lower risk of heart attack. Chronotype is the body's internal clock, which influences natural sleep-wake rhythms.
The study's findings suggest that aligning medication intake with these personal rhythms, such as nighttime for night owls and morning for early risers, may provide some protection against the cardiovascular risks associated with high blood pressure (hypertension).
In this new study, an international research team analyzed the medical records of approximately 5,300 participants. Following an in-depth evaluation of their chronotype (preferred sleep-wake schedule), the participants were randomly assigned to groups. Each group was instructed to take their blood pressure medicine at a specific time. The researchers then painstakingly observed all subjects over several months to determine the effect of drug scheduling on health outcomes.
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"These results are exciting because they could represent a paradigm shift in the treatment of hypertension," says Filippo Pigazzani, a cardiologist at the University of Dundee in the UK, who co-led the study.
The researchers claim that for the "first time" they have shown that considering a patient's chronotype when determining the appropriate dose time for antihypertensive medication – an approach termed personalized chronotherapy – could potentially decrease the risk of heart attack.
The research team focused on the potential impact of medication timing within the context of individual circadian rhythms. These 24-hour biological cycles, influenced by genetics and other factors, are known to control various physiological activities, including sleep patterns.
The researchers hypothesized that circadian rhythms, which are known to influence body temperature, hormone levels, and metabolism, could also help regulate blood pressure fluctuations throughout the day. Based on this hypothesis, they investigated whether the timing of blood pressure medication intake could be an important determinant. Previous studies on the subject have produced inconclusive results.
The study investigated the potential connection between medication timing and heart attack risk, beginning with a preliminary assessment of participants' chronotypes. This first phase considered the previously shown link between chronotypes and diseases such as anxiety and type 2 diabetes. The findings revealed that medication schedules that were not linked with individual chronotypes increased the risk of heart attack significantly. Also, this effect was strongest among "night owls," those who have a natural proclivity for late-night activities and who take their prescription in the morning.
"It's important for physicians to remember that not all patients are the same," says circadian biologist and co-lead author Kenneth Dyar, from Helmholtz Munich in Germany.
"Humans show wide inter-individual differences in their chronotype, and these personal differences are known to affect disease risk."
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Although the available data is inconclusive, it does provide interesting evidence for a possible link between blood pressure medication timing and the drugs' effectiveness. These preliminary findings have piqued the curiosity of experts, who are preparing more studies to confirm the findings. The ultimate aim is to determine whether specific medication schedules can optimize the efficacy of blood pressure treatments.
Dr. Pigazzani stresses the need for further confirmation through new randomized clinical trials before patients alter their antihypertensive medication schedules.
So the existing blood pressure medication guidelines should be followed for the time being. However, these new findings show promise for the future of individualized treatment. If further research confirms the relationship between medication timing and blood pressure control, a simple question like "Are you a morning person or a night owl?" by your doctor may become a crucial factor in choosing the best medication schedule for each patient. These personalized approaches may improve blood pressure management and ultimately reduce the risk of heart attacks.
The research has been published in eClinicalMedicine.
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