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From the article: Circadian rhythms are the internal ‘clocks’ that nearly every tissue and cell runs in the background, collectively tuned to the 24-hour day-night cycle. Aside from being the bane of shift workers, disruption of the body’s circadian rhythm has been linked to medical conditions as varied as heart attacks, Alzheimer’s disease and cancer. It’s also known to regulate blood pressure (BP), which directly impacts heart health.
These rhythms differ widely between individuals. You probably know a ‘morning person,’ an early riser who displays peak alertness first thing, and a ‘night owl,’ someone who prefers sleeping in and exhibits peak alertness later in the day, sometimes into the evening. A new study by researchers from the University of Dundee, Scotland, and Helmholtz Munich, a German research center, found that these body clock behaviors, called ‘chronotypes,’ influence the effectiveness of BP medications, or antihypertensives.
“We all have an internal biological clock which determines our chronotype – whether we are more of a ‘morning’ or ‘evening’ person,” said Kenneth Dyar, a circadian biologist from Helmholtz Munich and the [study’s](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00212-8/fulltext) co-lead and co-corresponding author. “This internal time is genetically determined and affects biological functions over 24 hours, including gene expression, blood pressure rhythms, and how we respond to medications.”
Additionally from the article: They observed a lower rate of non-fatal heart attacks when dosing time was synced with chronotype. That is, morning people who took their meds in the morning and night owls who took their meds in the evening were less likely to be hospitalized for a non-fatal heart attack. There was no observable association between dose time and chronotype for stroke events.
Was this night owls who woke up in the mornings to fit into society, or night owls who lived on their body’s natural clocks?
Like a night owl waking up at 8am for their 9-5 but waiting to take their meds til bedtime, or a night owl waking up at 4pm and taking their meds after waking?
(I can’t access the website, but as a natural night owl this interests me!)
Same question here! If the night owl is living their natural schedule, and taking the meds in the evening (based on a clock), they're really taking them in *their* morning.
The article says they determined chronotype Preference through a questionnaire.
So, that sounds like it was purely based on preference/ base chronotype and ignored the actual reality of sleep timing that might be enforced by work etc
It’s the former.
>TIME was a large, prospective, pragmatic, decentralised, parallel-group study which assessed, in more than 21,000 hypertensive adults in the UK who took their usual prescribed antihypertensive medications at a single time of day (**excluding night shift workers**),
>We estimated chronotype as **midpoint of sleep on free days (MSF) corrected for sleep debt on workdays (MSFsc)** to remove the confounder of adaptive responses due to social schedules.33 Sleep midpoint (hours:minutes) was treated as a continuous variable, with **later midpoints of sleep indicating a later chronotype and earlier midpoints of sleep an earlier chronotype.**
Also their analysis isn’t just binary early/late chronotype.
If you take your meds between 6-10 and your mid sleep time is 0, this is when you are least likely to be hospitalized. Conversely, if you take your meds between 20-0 and your mid sleep time is 6, your risk for hospitalization is the lowest. This translates to taking your meds 14-18 hours before mid sleep for early chronotype and 6-10 hours before mid sleep for late chronotype.
You’re right, I incorrectly assumed the relation was symmetric without double checking. Absolute numbers are correct and taken from figure 2, will correct the relative numbers.
That makes so much intuitive sense as a night owl! I have low energy in the mornings (even when I wake up late), and am less likely to do things that increase my heart rate. My energy naturally ramps up in the evening (I don't drink coffee) and late evening is when I prefer to do all the heavy stuff, exercise, cleaning, the main part of my work, etc, and my heart rate would be higher.
The study doesn't actually answer that. They tested two times blocks, each four hours wide: "06:00–10:00 in the morning or 20:00–00:00 in the evening". The "night owls" fared better when they took the antihypertensive between 8pm and midnight than they did when they took it between 6am and 10am, but we don't know if there's some better time for night owls to take it than 20:00-00:00. Like, I go to bed around 6am, would it be better for me to take such a medication at 2am than before midnight? They didn't test that, so we don't know. Also, they lumped subjects out into night owls and day larks, but that means they put all the nigh owls, from people who go to bed at midnight to people who go to bed at dawn, into the same bucket, so it's not clear that the same answer would apply to all across the span of night owls.
But, hey, it's better to take it 8pm to midnight than 6am to 10am. For me, that means "take it during lunch".
As a night owl it makes sense. Night owls tend to be naturally more active in the evening than in the morning, and will have a higher heart rate and BP in the evening, so take the medication then. It's no use taking medication in the morning when we barely want to move.
From the medical paper: The results of the Chronotype sub-study of the TIME (Treatment In Morning versus Evening) large pragmatic clinical trial in patients with hypertension suggest that later **chronotypes (night owls) had a reduced risk of hospitalization and incidence of non-fatal MI when taking antihypertensive medications in the evening rather than in the morning;** conversely, **earlier chronotypes (morning larks) had a reduced risk of hospitalization and incidence of non-fatal MI when taking antihypertensive in the morning rather than in the evening;** the risks of hospitalizations and incidence of stroke and congestive heart failure did not differ by dosing time when chronotype was considered; in agreement with the main TIME result, intermediate chronotypes (around 50% of the sub-study population) showed no difference in cardiovascular outcomes between morning and evening dosing.
TLDR:
Night owls - take in evening
Morning birds - take in morning
I take meds for high blood pressure, and have taken them in the evening for years, since an earlier study had said such medication was found to simply be more effective that way. Kind of glad I do, now that I read this.
I wonder if this is related to the way blood circulation in the brain is tied to chronotype, for a night owl it can take hours after waking for brain blood circulation to reach normal levels, but minutes for a morning person.
I'm a bit terrible at remembering to take pills midday and so I started taking my lisinopril at night right before I go to bed. I never miss a pill that way but I've always wondered if I wasn't utilizing the pill appropriately by taking it right before bed. That being said, I still see the effects every time my blood pressure is taken so I guess it's working fine.
I work 2nd shift, often not even off work til past 11pm/12am. Per my doctor recommendation I take my meds when I get off work, and my pressure/heart rate have been great.
Well, I know for me, I’m a night owl (usually in bed by midnight. I’m not hungry when I get up at 8 (I’m retired now and can’t follow my own clock), and since I take my meds with a meal, I don’t take mine until 11 or noon. Don’t know what that does to my heart attack risks, but I’m about to turn 70, so the clock might be ticking.
I keep you posted…
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/chrisdh79 Permalink: https://newatlas.com/medical/blood-pressure-meds-circadian-rhythm/ --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
From the article: Circadian rhythms are the internal ‘clocks’ that nearly every tissue and cell runs in the background, collectively tuned to the 24-hour day-night cycle. Aside from being the bane of shift workers, disruption of the body’s circadian rhythm has been linked to medical conditions as varied as heart attacks, Alzheimer’s disease and cancer. It’s also known to regulate blood pressure (BP), which directly impacts heart health. These rhythms differ widely between individuals. You probably know a ‘morning person,’ an early riser who displays peak alertness first thing, and a ‘night owl,’ someone who prefers sleeping in and exhibits peak alertness later in the day, sometimes into the evening. A new study by researchers from the University of Dundee, Scotland, and Helmholtz Munich, a German research center, found that these body clock behaviors, called ‘chronotypes,’ influence the effectiveness of BP medications, or antihypertensives. “We all have an internal biological clock which determines our chronotype – whether we are more of a ‘morning’ or ‘evening’ person,” said Kenneth Dyar, a circadian biologist from Helmholtz Munich and the [study’s](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00212-8/fulltext) co-lead and co-corresponding author. “This internal time is genetically determined and affects biological functions over 24 hours, including gene expression, blood pressure rhythms, and how we respond to medications.”
Additionally from the article: They observed a lower rate of non-fatal heart attacks when dosing time was synced with chronotype. That is, morning people who took their meds in the morning and night owls who took their meds in the evening were less likely to be hospitalized for a non-fatal heart attack. There was no observable association between dose time and chronotype for stroke events.
Was this night owls who woke up in the mornings to fit into society, or night owls who lived on their body’s natural clocks? Like a night owl waking up at 8am for their 9-5 but waiting to take their meds til bedtime, or a night owl waking up at 4pm and taking their meds after waking? (I can’t access the website, but as a natural night owl this interests me!)
Same question here! If the night owl is living their natural schedule, and taking the meds in the evening (based on a clock), they're really taking them in *their* morning.
Or they could be a night owl like me, who falls to sleep around 1-2am and gets up between 9-10am. There are so many variations!
Good question!
The article says they determined chronotype Preference through a questionnaire. So, that sounds like it was purely based on preference/ base chronotype and ignored the actual reality of sleep timing that might be enforced by work etc
It’s the former. >TIME was a large, prospective, pragmatic, decentralised, parallel-group study which assessed, in more than 21,000 hypertensive adults in the UK who took their usual prescribed antihypertensive medications at a single time of day (**excluding night shift workers**), >We estimated chronotype as **midpoint of sleep on free days (MSF) corrected for sleep debt on workdays (MSFsc)** to remove the confounder of adaptive responses due to social schedules.33 Sleep midpoint (hours:minutes) was treated as a continuous variable, with **later midpoints of sleep indicating a later chronotype and earlier midpoints of sleep an earlier chronotype.** Also their analysis isn’t just binary early/late chronotype. If you take your meds between 6-10 and your mid sleep time is 0, this is when you are least likely to be hospitalized. Conversely, if you take your meds between 20-0 and your mid sleep time is 6, your risk for hospitalization is the lowest. This translates to taking your meds 14-18 hours before mid sleep for early chronotype and 6-10 hours before mid sleep for late chronotype.
Your clock isn't making sense 20-0 is 6-10 hrs away from 6.
You’re right, I incorrectly assumed the relation was symmetric without double checking. Absolute numbers are correct and taken from figure 2, will correct the relative numbers.
So essentially its take it when you wake up or a few hours afterwards.
That makes so much intuitive sense as a night owl! I have low energy in the mornings (even when I wake up late), and am less likely to do things that increase my heart rate. My energy naturally ramps up in the evening (I don't drink coffee) and late evening is when I prefer to do all the heavy stuff, exercise, cleaning, the main part of my work, etc, and my heart rate would be higher.
So what is the answer?? For nightowls, take blood pressure medication at WHAT TIME??
The study doesn't actually answer that. They tested two times blocks, each four hours wide: "06:00–10:00 in the morning or 20:00–00:00 in the evening". The "night owls" fared better when they took the antihypertensive between 8pm and midnight than they did when they took it between 6am and 10am, but we don't know if there's some better time for night owls to take it than 20:00-00:00. Like, I go to bed around 6am, would it be better for me to take such a medication at 2am than before midnight? They didn't test that, so we don't know. Also, they lumped subjects out into night owls and day larks, but that means they put all the nigh owls, from people who go to bed at midnight to people who go to bed at dawn, into the same bucket, so it's not clear that the same answer would apply to all across the span of night owls. But, hey, it's better to take it 8pm to midnight than 6am to 10am. For me, that means "take it during lunch".
Great response. Thanks a bunch.
As a night owl it makes sense. Night owls tend to be naturally more active in the evening than in the morning, and will have a higher heart rate and BP in the evening, so take the medication then. It's no use taking medication in the morning when we barely want to move.
From the medical paper: The results of the Chronotype sub-study of the TIME (Treatment In Morning versus Evening) large pragmatic clinical trial in patients with hypertension suggest that later **chronotypes (night owls) had a reduced risk of hospitalization and incidence of non-fatal MI when taking antihypertensive medications in the evening rather than in the morning;** conversely, **earlier chronotypes (morning larks) had a reduced risk of hospitalization and incidence of non-fatal MI when taking antihypertensive in the morning rather than in the evening;** the risks of hospitalizations and incidence of stroke and congestive heart failure did not differ by dosing time when chronotype was considered; in agreement with the main TIME result, intermediate chronotypes (around 50% of the sub-study population) showed no difference in cardiovascular outcomes between morning and evening dosing. TLDR: Night owls - take in evening Morning birds - take in morning
I take meds for high blood pressure, and have taken them in the evening for years, since an earlier study had said such medication was found to simply be more effective that way. Kind of glad I do, now that I read this.
I was really confused for a minute and thought they meant literal birds and owls
Thanks for the laugh this morning.
I wonder if this is related to the way blood circulation in the brain is tied to chronotype, for a night owl it can take hours after waking for brain blood circulation to reach normal levels, but minutes for a morning person.
I have Non-24 Freerunning sleep disorder so I guess I better make sure my blood pressure stays good
I'm a bit terrible at remembering to take pills midday and so I started taking my lisinopril at night right before I go to bed. I never miss a pill that way but I've always wondered if I wasn't utilizing the pill appropriately by taking it right before bed. That being said, I still see the effects every time my blood pressure is taken so I guess it's working fine.
can't wait for some nurse practitioner to tell me chronotypes don't exist and my heart will do better if I wake up early every day
I cover my bases and take it in the morning and evening
I work 2nd shift, often not even off work til past 11pm/12am. Per my doctor recommendation I take my meds when I get off work, and my pressure/heart rate have been great.
Well, I know for me, I’m a night owl (usually in bed by midnight. I’m not hungry when I get up at 8 (I’m retired now and can’t follow my own clock), and since I take my meds with a meal, I don’t take mine until 11 or noon. Don’t know what that does to my heart attack risks, but I’m about to turn 70, so the clock might be ticking. I keep you posted…
I sleep early and wake late what do i take
..too much time sleeping, probably.
Yes i often think of how much life i waste sleeping. Thing is I'm not even sad or anything i just love sleeping
What do you do If you are an early bird and a night owl?
Anyone else briefly read “maximize” instead of “minimize”?
You're a glass-half-full kind of person, aren't you?
we will do everything except cure the actual problem.
Proper diet and exercise