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Taking medications according to the biological clock reduces the risk of heart attack

Studies have shown that hypertensive patients who take antihypertensive medications at a time consistent with their biological clock have a reduced risk of heart attack.

Research carried out at the University of Dundee School of Medicine has revealed a person’s chronotype – the time at which they feel most suitable for sleeping and waking can influence how they interact with blood pressure medicines.

The research was carried out in cooperation with Helmholtz Munich and a team of scientists from Italy, Great Britain and the USA.

More than 5,000 people taking part in the Morning vs. Evening (Time) Treatment study completed an online questionnaire that assessed the tuning of their body clock, with about half of respondents saying they took their medications in the morning and the other half in the evening.

The researchers observed that so-called “morning larks” (earlier chronotypes) who took their prescribed blood pressure medications in the morning were less likely to have a heart attack compared to those who were “misaligned” and took them in the evening.

Meanwhile, study participants who were “night owls” (later chronotypes) and took their blood pressure medications in the evening were also less likely to be hospitalized for a heart attack compared to those who took their medications in the morning.

The team concluded that respondents who took their medications at times they felt more comfortable with could better protect their hearts.

Dr Filippo Pigazzani, senior clinical lecturer and honorary consultant cardiologist at the University of Dundee, said: “These results are exciting because they could represent a paradigm shift in the management of hypertension.

“Our research has shown for the first time that taking chronotype into account when deciding on the timing of antihypertensive drug dosing – i.e. personalized chronotherapy – can reduce the risk of heart attack.

“However, before any patient changes 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 body clock that determines our chronotype – whether we are more morning or evening people.

“This internal timing is genetically determined and influences biological functions over a 24-hour period, including gene expression, blood pressure rhythms, and our response to medications.

“It is important for physicians to remember that not all patients are the same. “People show large inter-individual differences in their chronotype, and these personal differences are known to influence disease risk.”

High blood pressure (hypertension) has a significant impact on public health.

People with hypertension are more likely than the general population to have a heart attack, stroke and heart failure.

The study authors emphasized that patients should continue taking their medications as prescribed by their doctor.

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