‘Exciting’ research links timing of medication with heart attack risk

Research has shown that patients with high blood pressure who take blood pressure medication at a time aligned with their body clock have a reduced risk of having a heart attack. Research at the University of Dundee’s School of Medicine has revealed that a person’s chronotype – when they feel best asleep and most awake – can influence how they interact with blood pressure medication.

The research was undertaken in collaboration with Helmholtz Munich and a team of scientists from Italy, the UK and the US. More than 5,000 people in the Morning vs. Evening Treatment (Time) study completed an online questionnaire that assessed how their body clock is set, with about half of respondents saying they take their medication in the morning and the other half in the evening.

The scientists observed that the so-called “previous chronotypes” who took their prescribed blood pressure medication in the morning were less likely to suffer a heart attack than those who were “misaligned” and took it in the evening. Meanwhile, study participants who were “night owls” (later chronotypes) and took their blood pressure medication in the evening were also less likely to be hospitalized for a heart attack compared to those who they took their medicine in the morning. The team concluded that respondents who took their medication at times when they felt more fit might better protect their hearts.

Dr Filippo Pigazzani, Senior Clinical Lecturer and Honorary Consultant Cardiologist at the University of Dundee, said: ‘These results are exciting as they could represent a paradigm shift in the treatment of hypertension. the time of antihypertensives – personalized chronotherapy – could reduce the risk of heart attack. However, before any patients change when they take their antihypertensive medications, our findings must first be confirmed in new randomized clinical trials of personalized chronotherapy.

Dr. Kenneth Dyar, a circadian biologist at Helmholtz Munich, who helped design the study, added: “We all have an internal biological clock that determines our chronotype – whether we are more of a morning or evening person. This internal time is genetically determined and affects biological functions over the course of 24 hours, including gene expression, blood pressure rhythms, and how we respond to drugs.

“It’s important for doctors to remember that not all patients are the same. Humans show large inter-individual differences in their chronotype, and these individual differences are known to affect disease risk.”

High blood pressure (hypertension) has a significant impact on public health. People with high blood pressure are more likely than the general population to have a heart attack, stroke, and heart failure. The study authors stressed that patients should continue to take their medications as directed by their doctor.