Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse and blood pressure are higher in the early morning hours.

Thus, controlling early morning blood pressure can help reduce cardiovascular mortality.According to a study published in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure, taking at least one antihypertensive drug at bedtime significantly improved blood pressure control, with an associated decreased risk for cardiovascular events.

The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti-BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years; during that time, patients who took at least 1 BP-lowering drug at bedtime had approximately one-third of the cardiac risk compared to those who took all medications on awakening. Bedtime dosing was also associated with a similar significant reduction in cardiac deaths, heart attacks and paralysis.Patients taking medications at bedtime also had a significantly lower mean BP while sleeping. For each 5 mmHg reduction in mean sleep-time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow-up. The benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced following bedtime, but not morning, treatment.