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Around half of them took powerful antipsychotic medications at bedtime to help them sleep, officials said.
(B) Administer one or more antihypertensive medications at bedtime.
At the final evaluation, the percentages of patients in the experimental group ingesting 1, 2, or ≥3 medications at bedtime were 56.5, 25.0, and 18.5%, respectively.
The results document, first, greater ambulatory blood pressure control in patients ingesting ≥1 hypertension medications at bedtime than in those ingesting all their medications upon awakening.
Patients ingesting ≥1 blood pressure lowering medications at bedtime evidenced a significantly lower risk of total events than patients ingesting all of their medications upon awakening (hazard ratio 0.33 [95% CI 0.21 0.54]; P < 0.001).
Among patients with diabetes, treatment with ≥1 hypertension medications at bedtime, compared with all medications upon waking, resulted in improved ambulatory blood pressure control and significantly reduced cardiovascular morbidity and mortality.
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"I think abnormal behaviors like those could be unmasked in a small minority of patients taking any medications in that class, and the most common administered medication at bedtime is Ambien at this time," said Dr. John W. Winkelman, medical director of the Sleep Health Center at Brigham and Women's Hospital in Boston.
This difference in ambulatory blood pressure control was mainly due to improved sleep time blood pressure control in subjects ingesting medication at bedtime.
A positive outcome for the primary end point of the trial may pave the way for dosing antihypertensive medication at bedtime.
The percentage of patients treated with ≥1 hypertension medication at bedtime was lower (41%) in the first than in the second quintile (57%; P = 0.037).
Likewise, parents reported that the percentage of children with ADHD whose behaviour affected the relationship with their sibling(s) was significantly higher in the group receiving medication at bedtime (34% vs 27%, respectively; p < 0.05).
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