High blood pressure at night is much more dangerous

Preventing blood pressure at bedtime can reduce cardiovascular risks

A study by Spanish researchers has shown that high blood pressure levels at night increase the risk of cardiovascular disease even more than the same values ​​during the day. By taking antihypertensives at bedtime this risk can be significantly reduced.

Risk factor for dangerous cardiovascular diseases

Hypertension is a widespread disease, especially in the Western world. In this country, according to the German High Pressure League (DHL) about 20 to 30 million people are affected. High blood pressure is a major 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 needs to be treated with medication. Researchers now report that taking antihypertensive drugs at bedtime can more effectively reduce cardiovascular risk.

One study has shown that high blood pressure is the most dangerous at night. Therefore, according to researchers, it may be advisable in some patients to take antihypertensive medication at bedtime. (Image: leszekglasner / fotolia.com)

Measuring blood pressure during sleep

Even though hundreds of millions of people worldwide have hypertension, few people know how their blood pressure levels are during sleep.

However, some patients take blood pressure measurements during the nocturnal break during 24- or 48-hour outpatient measurements.

Spanish scientists have now done this as part of a study of more than 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 journal "European Heart Journal", the researchers around 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 had hypertension.

The study lowered the blood pressure of these participants with medication. The subjects were divided into two groups.

One group took the antihypertensive only during the day, the other should take at least one preparation in the evening just before going to bed.

For all patients, blood pressure was measured several times at the beginning of the study and at each follow-up visit, which took place at least once a year.

In addition, the blood pressure history of all subjects was recorded after each consultation with an ambulatory blood pressure monitor 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 nocturnal hypertension

According to the scientists, a cardiovascular event occurred during the study period (the median observation period was five years) in 2,311 people (12.8 percent of the participants).

In 1,209 cases, the event had serious consequences such as cardiac death, heart failure, infarction, heart failure or stroke.

According to the data, the serious events particularly affected older male patients suffering from several diseases.

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 baseline had a 34% increased risk of cardiovascular events.

In subjects with nocturnal systolic blood pressure> 120 mmHg, the risk even increased by 62 percent.

However, subjects without cardiovascular problems had an approximately nine mmHg lower average systolic blood pressure during sleep than patients with cardiovascular events.

If necessary, take antihypertensives in the evening

The study thus confirmed that hypertension during sleep is associated with a significantly increased risk of cardiovascular events.

In addition, it was also shown that taking an antihypertensive in the evening could reduce this risk for patients by more than half.

The authors therefore recommend that blood pressure levels in hypertensive patients be determined during sleep, for example via 48 or 24-hour blood pressure measurements.

If an elevated blood pressure is detected at night, at least one antihypertensive should be taken at night. (Ad)