Data unveiled today at
the American Society of
Hypertension's Twenty
Third Annual Scientific
Meeting and Exposition
(ASH 2008) revealed for
the first time that
people with
prehypertension who are
treated with aspirin may
experience significant
reductions in blood
pressure—but only if
they take the pill
before bedtime, and not
when they wake up in the
morning.
People with
prehypertension (a blood
pressure reading between
normal and high; when
systolic blood pressure
is between 120 and 139
or diastolic blood
pressure is between 80
and 89 on multiple
readings) are at
significant risk of
hypertension, or
consistently high blood
pressure—the biggest
risk factor for heart
disease and stroke, the
two leading causes of
death in the Western
world.
“This is the first
study to reveal that
taking aspirin before
bedtime as opposed to
upon waking in the
morning is an effective
strategy to lower blood
pressure and cost
effective way to
individualize treatment
regimes in
pre-hypertensive
patients," said lead
investigator Prof. Ramón
C. Hermida, Director of
Bioengineering and
Chronobiology at the
University of Vigo in
Spain. "These findings
therefore have vital
treatment implications
for these at-risk
patients throughout the
world.”
The purposeful timing
of medications in order
to enhance beneficial
outcomes or to avert
adverse effects is known
as ‘chronotherapeutics’.
Although factors
influencing why aspirin
has an impact on
prehypertensive patients
in the evening and not
the morning are somewhat
unclear, researchers
indicate that it could
be because aspirin slows
down the production of
hormones and other
substances in the body
that cause clotting.
Many of those are
produced while the body
is at rest.
The study, which ran
for three months,
involved 244
participants (97 men and
138 women of 43.0±13.0
years of age) all of
whom had all received
diagnoses for
prehypertension.
Participants were
divided into three
groups: non
pharmacological
hygienic-dietary
recommendations (HDR):
HDR and a 100mg tablet
of aspirin (ASA) on
awakening or HDR and ASA
at bedtime. Blood
pressure levels were
monitored at 20 minute
intervals from 7:00 a.m.
to 11:00 p.m. and at
30-min intervals at
night for 48 consecutive
hours at baseline and
after three months of
intervention. Physical
activity was
simultaneously monitored
every minute by wrist (actigraphy)
to accurately calculate
sleeping and waking
blood pressure on an
individual basis.
The results showed
that those who had taken
aspirin before they went
to bed (at an average
time of 11:00 p.m.),
decreased their systolic
blood pressure by an
average of 5.4 mmHg and
their diastolic blood
pressure by an average
of 3.4 mmHg over the
three-month study,
without any change in
heart rate of physical
activity compared to
baseline values
(p<0.001). This blood
pressure reduction was
similar during active
hours (5.6 and 3.7 mmHg
reduction in systolic
and diastolic BP,
p<0.001) and the
nocturnal resting span
(5.2 and 3.1 mmHg,
respectively). Those who
took a morning aspirin,
usually at about 8:00
a.m., saw no reduction
in ambulatory blood
pressure at all, nor did
participants in the HDR-only
group.
“These results show
us that we cannot
underestimate the impact
of the body's circadian
rhythms," said Hermida.
"The beneficial effects
of time-dependent
administration of
aspirin have, until now,
been largely unknown in
people with
prehypertension.
Personalizing treatment
according to one's own
rhythms gives us a new
option to optimize blood
pressure control and
reduce risk of
cardiovascular disease
down the line."
Natural ways to lower B.P.
You can lower your BP with
hyperventilation deep breathing for 5 minutes will lower the
blood pressure and this should be done every morning.