chronotherapy - The practice of timing drugs at certain times of the day
Do not undertake any changes without talking to your doctor. You'll know how up-to-date your doctor is if they can reference this study when talking to you.
http://www.nature.com/hr/journal/vaop/ncurrent/full/hr2015142a.html
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Abstract
Correlation
between blood pressure (BP) and target organ damage, vascular risk and
long-term patient prognosis is greater for measurements derived from
around-the-clock ambulatory BP monitoring than in-clinic daytime ones.
Numerous studies consistently substantiate the asleep BP mean is both an
independent and a much better predictor of cardiovascular disease (CVD)
risk than either the awake or 24 h
means. Sleep-time hypertension is much more prevalent than suspected,
not only in patients with sleep disorders, but also among those who are
elderly or have type 2 diabetes, chronic kidney disease or resistant
hypertension. Hence, cost-effective adequate control of sleep-time BP is
of marked clinical relevance. Ingestion time, according to circadian
rhythms, of hypertension medications of six different classes and their
combinations significantly affects BP control, particularly sleep-time
BP, and adverse effects. For example, because the high-amplitude
circadian rhythm of the renin–angiotensin–aldosterone system activates
during nighttime sleep, bedtime vs. morning ingestion of
angiotensin-converting enzyme inhibitors and angiotensin receptor
blockers better reduces the asleep BP mean, with additional benefit,
independent of medication terminal half-life, of converting the 24 h
BP profile into more normal dipper patterning. The MAPEC
(Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares)
study, first prospective randomized treatment-time investigation
designed to test the worthiness of bedtime chronotherapy with 
1
conventional hypertension medications so as to specifically target
attenuation of asleep BP, demonstrated, relative to conventional morning
therapy, 61% reduction of total CVD events and 67%
decrease of major CVD events, that is, CVD death, myocardial
infarction, and ischemic and hemorrhagic stroke. The MAPEC study, along
with other earlier conducted less refined trials, documents the asleep
BP mean is the most significant prognostic marker of CVD morbidity and
mortality; moreover, it substantiates attenuation of the asleep BP mean
by a bedtime hypertension treatment strategy entailing the entire daily
dose of 1
hypertension medications significantly reduces CVD risk in both general
and more vulnerable hypertensive patients, that is, those diagnosed
with chronic kidney disease, diabetes and resistant hypertension.
1
conventional hypertension medications so as to specifically target
attenuation of asleep BP, demonstrated, relative to conventional morning
therapy, 61% reduction of total CVD events and 67%
decrease of major CVD events, that is, CVD death, myocardial
infarction, and ischemic and hemorrhagic stroke. The MAPEC study, along
with other earlier conducted less refined trials, documents the asleep
BP mean is the most significant prognostic marker of CVD morbidity and
mortality; moreover, it substantiates attenuation of the asleep BP mean
by a bedtime hypertension treatment strategy entailing the entire daily
dose of 1
hypertension medications significantly reduces CVD risk in both general
and more vulnerable hypertensive patients, that is, those diagnosed
with chronic kidney disease, diabetes and resistant hypertension.
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