Blood pressure medication before bed could lower risk of diabetes

IT MAY sound simple, but something as basic as taking your blood pressure medication before bed rather than in the morning could be enough to lower the risk of type 2 diabetes significantly, according to new research. Two studies conducted by researchers from the University of Vigo in Spain have explored the impact of sleep-time blood pressure on new-onset diabetes risk. The findings are published in the journal Diabetologia.
According to the Centres for Disease Control and Prevention (CDC), around 1 in 3 adults in the US have high blood pressure – around 70 million adults, or 29% of the population. However, only 52% of people with high blood pressure, often referred to as hypertension, have control of their condition, When uncontrolled, high blood pressure can lead to metabolic syndrome, a collection of disorders that increases the risk of heart disease, stroke and diabetes.
In the first study, Dr. Ramón Hermida and colleagues set out to investigate the value of using blood pressure to predict new-onset diabetes, prospectively examining 2,656 individuals of varying blood pressure levels who did not have diabetes at the beginning of the study. After an average of 5.9 years of follow-up, 190 participants had developed type 2 diabetes. The researchers found that sleep-time blood pressure levels were a significant marker for the development of diabetes, with alterations in blood pressure preceding rather than following the onset of the disease.
This first study suggested to the researchers that lowering sleep-time blood pressure could be a novel method for reducing the risk of new-onset diabetes. In the second study, Dr. Hermida and colleagues aimed to test whether taking hypertension medication before sleeping was more effective at reducing the risk of diabetes than taking medication after waking up. For this study, 2,012 people with high blood pressure were randomly assigned to either take all of their hypertension medication upon awakening or to take the entire daily dose of one or more of their prescribed medication at bedtime.
None of the participants had diabetes at the start of the study, and the researchers tracked the developed of the disease for a median of 6 years. During the follow-up period, 171 participants developed type 2 diabetes. Those who were assigned to take their medication before bedtime had significantly lower average sleep-time blood pressure and a greater sleep-time relative blood pressure decline than those who took their medication in the morning.
Prevalence of “non-dipping” – whereby blood pressure during sleep-time falls by less than 10% compared with daytime blood pressure – was lower in those who took their medication at bedtime. Non-dipping occurred in 32% of this group compared with 52% of those who took their medication in the morning. Most importantly, however, was the finding that the risk of new-onset type 2 diabetes decreased by 57% in the group of patients who took their medicine before bedtime.

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