When is the best time to take blood pressure medication?

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Normally, most patients take their blood pressure medication in the morning, although no trial has made this recommendation. However, a new study shows that taking blood pressure medication at bedtime instead of when you wake up can reduce the risk of death from cardiovascular events by 50%.

1. Benefits of choosing the time to take blood pressure medication

1.1 Helps better control blood pressure Currently, the use of blood pressure drugs is mostly in slow-release dosage forms, with effects lasting for 24 hours and doctors usually prescribe 1-2 tablets for patients to take. in the morning, once a day. In healthy subjects, blood pressure always decreased at night while sleeping, but in patients with high blood pressure, blood pressure at night did not decrease or decreased significantly compared to the day (despite morning medication). ). If blood pressure is not well controlled at night, it will easily increase in the morning. Therefore, scientists have recently re-researched and shown that, if changing blood pressure medication in the morning to evening will control blood pressure more stable during sleep.

Scientists in Spain followed more than 19,000 adults with hypertension. They found that patients who took all their blood pressure medication at night had lower blood pressure readings over the course of 24 hours than those who took their medication in the morning. In addition, taking blood pressure medication before going to bed at night also helps improve blood fat. This conclusion holds for all genders, ages, and people with comorbidities (eg, diabetes or kidney disease), and takes into account all other risk factors, the study's authors said. increase blood pressure.
1.2 Helps reduce the risk of death Researchers also found that people who always took the pill at night reduced their risk of death from heart or vascular events by two-thirds compared with those who had a habit of drinking. medicine in the morning.
Reports say that taking the pill before bed can:
Reduce the risk of a heart attack by 44%; 40% reduction in risk of coronary revascularization (surgery to widen the arterial passage); 42% lower risk of heart failure; 49% reduction in stroke risk. Overall, the results showed a 45 percent reduction in the risk of heart-related death.

The reason is because controlling blood pressure at night is very important. The doctors explained that sleep blood pressure is the most noticeable indicator of cardiovascular risk, whether daytime readings are normal or elevated. The group of patients taking the drug at night had a "significant decrease" in blood pressure during sleep, compared with those who followed the morning medication routine.
However, this conclusion was only true for subjects who followed a common sleep routine: waking up during the day and sleeping at night. That means the study can't say when is best for people who work at night. In addition, black Americans tend to have higher-than-average blood pressure elevations during sleep, so more cross-racial comparison studies are needed.
1.3 Reduces risk of diabetes Furthermore, the benefit of taking blood pressure medication at night is to help prevent diabetes. The scientists explain that hypertensive patients have a higher risk of diabetes and heart disease when blood pressure is not well controlled during sleep. Therefore, if blood pressure is always maintained at a stable level at night, it will prevent the progression to type 2 diabetes. In which hormones such as adrenaline and angiotensin play a role in the development of both high blood pressure and type 2 diabetes.

Besides when is the best time to take blood pressure medication, factors such as emotions and the simultaneous use of different drugs also affect the effectiveness of the medication. Some medications for high blood pressure also reduce the activity of angiotensin - the hormone that causes vasoconstriction and increases blood pressure. In addition, angiotensin also contributes to increased clearance of glucose (sugar) from the liver and decreased insulin sensitivity - factors that can lead to type 2 diabetes. Blood pressure drug classes are associated with a reduced risk diabetes if switched to taking the drug at night before bed is:
Angiotensin receptor blocker: 61% reduction; Beta-blockers: This rate increases to 65%; ACE inhibitor group: There is a rate up to 69%.

2. Why should you take blood pressure medication at a fixed time?

On the other hand, some cardiologists also believe that consistency in blood pressure medication habits is the key to optimal protection. Fluctuations in blood pressure due to non-compliance with routine medication (one missed dose) are even worse than elevated blood pressure. Therefore, to ensure compliance with the daily dose, it is important for patients to establish a habit of taking their medication at the same time each day.
Around the question "When to take blood pressure medicine?", there is also the notion that blood pressure medicine should be taken in the evening, to avoid insomnia due to nocturia and cause the kidneys to work a lot. Patients need to reduce water intake after noon, instead drink plenty of water in the morning to help the body excrete waste.

Scientists hope to be able to reach a final conclusion soon to give clinicians some information when instructing patients at what time to take their blood pressure medication. Until this point, people with high blood pressure should still consult with their doctor before changing the duration of their medication. Do not arbitrarily change the treatment regimen without consulting a specialist.

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Reference source: webmd.com