Taking a particular pill at particular time healthier: Study

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Washington, Dec 18 (UNI) Taking a blood pressure pill at bedtime instead of in the morning might be healthier for some high-risk people, a study said.

The new research suggests that simple switch may normalise patterns of blood pressure in patients at extra risk from the twin epidemics of heart and kidney disease, the Columbian reported.

In healthy people, blood pressure dips at night, by 10 to 20 per cent, the report said. Scientists suspect the drop gives arteries a little rest.

People with high blood pressure that doesn't dip at night - the non-dippers - fare worse than other hypertension sufferers, developing more serious heart disease, the study said.

The Italian researchers performed an easy test on blood pressure patients. They told 32 non-dippers with kidney disease to switch one of those drugs from morning to bedtime dose.

In two months, nearly 90 per cent of high-risk patients had turned into dippers. Their night time blood pressure dropped an average of seven points, without any side effects or increase in daytime blood pressure.

A key sign of kidney function improved significantly, too, said Dr Roberto Minutolo of the Second University of Naples, who reported it this month in the American Journal of Kidney Diseases.

While the Italian study is too small for proof, similar studies from Europe also back a bedtime switch for non-dippers.

''I think it's huge,'' said Dr Lawrence Appel of John Hopkins University. Dr Appel found 80 per cent of black kidney patients in a study were non-dippers and 40 per cent had night time blood pressure that was even higher than day time levels.

Two-thirds of chronic kidney disease patients, and at least 10 per cent of the general population, are estimated to be non-dippers, said Dr Joseph Vassalotti of the National Kidney Foundation. One theory is that their bodies have trouble excreting salt.

Most patients who take several once-a-day pills swallow them all in the morning, meaning they all start wearing off around the same time, said Dr Gina Lundberg of St Joseph's Hospital in Atlanta.

''It does make good sense to take some in the morning and some in the evening,'' said Dr Lundberg, a spokeswoman for the American Heart Association.

Everyone has an internal clock, determined by genes, that affects health. Many of these biological rhythms are circadian, meaning they fluctuate on a 24-hour cycle.

The new Italian study marks an important advance, said Dr Mahboob Rahman of the University Hospitals of Cleveland. ''We know now that you can change medication timing and lower blood pressure at night,'' he explained.

That doesn't mean everyone should switch to bedtime dosing.

Morning may be best for people on just one drug, and no one yet knows if the switch truly gives non-dippers better overall health.

''That's the million-dollar question,'' Dr Rahman cautions.

Still, Dr Lundberg said it's worth asking your doctor how to time doses, say one at night for someone taking multiple medicines couldn't hurt.


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