No best time of day to take blood pressure medication

Blood pressure medication can be effective at any time of day, a study funded by the charity the British Heart Foundation has concluded.

With the annual blood pressure awareness campaign Know your numbers! week taking place next week (5-12 September), the findings, announced at the European Society of Cardiology in Barcelona, supersedes earlier studies that have suggested blood pressure-lowering medication can be more effective when taken in the evening.

More than 20,000 took part in the Treatment in morning versus evening (TIME) study, with half asked to take their blood pressure-lowering medication in the morning and the other half in the evening.

Everyone involved was followed up for an average of five years. The results showed that there was no difference in the number of people who had a heart attack, stroke or died whether they look their medication in the morning or the evening, said the BHF.

The research was just one of a number of papers funded by BHF and presented at the congress, which took place from 26-29 August.

A University of Oxford study, for example, has concluded that statins are not necessarily the cause of the muscle pain commonly experienced by people taking the medication.

Statins are among the most prescribed medications in the UK, with up to eight million adults taking them to reduce levels of low density lipoprotein (LDL, or also called ‘bad’) cholesterol in their blood.

Side effects, particularly muscle weakness or pain, have often been reported by many people who take statins.

The researchers compiled data from 23 large studies into statins involving nearly 155,000 people.

The results showed that statins were not the cause of the muscle pain in more than 90% of people who experienced symptoms.

Professor Sir Nilesh Samani, BHF medical director, said: “It is vital that the genuine concerns of people who do experience muscle symptoms are not dismissed and that doctors have continued consultations with these patients to ensure their medication is tailored to work best for them.”

Another finding from the congress is that combining medications into a single ‘polypill’ can be more effective in treating people who have had a heart attack.

When someone experiences a cardiac arrest, they are normally prescribed several different medications to lower the risk of a further cardiac event.

The ‘SECURE’ trial, which involved around 2,500 people who had a heart attack less than six months ago, suggests that combining these drugs into a single pill could be more effective, the congress heard.

Half of the trial participants were randomly chosen to take a ‘polypill’ containing aspirin to prevent blood clots, the cholesterol-reducing drug atorvastatin, and ramipril, which lowers blood pressure. The other half were assigned to receive usual care and took all three drugs separately.

Researchers then followed up with the patients after three years. They found that the number of deaths from heart and circulatory conditions, along with the number of further heart attacks or stroke, was lower in the group of patients that had taken the polypill.

Patients in the polypill group were also more likely to continue taking their medication than those in the usual care group.

Professor Samani added: “This study shows that combining these drugs into a single ‘polypill’ may improve compliance and reduce future cardiac events, compared with taking the drugs separately. If these results are confirmed in other studies, a polypill may become the preferred way of giving these drugs to most patients after a heart attack.”