American Board of Internal Medicine (ABIM) Certification Practice Exam

What impact does bedtime ingestion of hypertension medication have for patients?

1. Reduces the risk of new-onset type 2 diabetes

2. Decreases blood pressure overnight

3. Improves renal function

4. Leads to better medication adherence

The correct answer is: Reduces the risk of new-onset type 2 diabetes

Bedtime ingestion of hypertension medication has been shown to have specific cardiovascular benefits, particularly concerning blood pressure control during the nighttime hours. The primary impact of taking hypertension medication at bedtime is the significant decrease in blood pressure while the patient sleeps. This is important because elevated nighttime blood pressure is associated with an increased risk of cardiovascular events and may contribute to organ damage, particularly in the kidneys and heart. In contrast, while reducing the risk of new-onset type 2 diabetes can be a secondary benefit linked to better overall metabolic control, it is not the direct impact of taking medication at bedtime. Similarly, while improved renal function might be a long-term benefit of effective blood pressure control, it does not directly stem from the timing of medication ingestion. Medication adherence may improve with a bedtime regimen, but the key benefit emphasized in studies is the reduction in overnight blood pressure, which directly correlates with better overall outcomes in managing hypertension. Thus, the noted impact of bedtime ingestion is the critical decrease in overnight blood pressure, which is a pivotal factor in reducing overall cardiovascular risk.