Is nighttime the right time for blood pressure medications?

Hypertension is a chronic disease that requires the patient to take medication for life, in order to control the blood pressure index stably, avoiding the risk of cardiovascular progression. Taking medication for hypertensive patients is not uncommon, but not everyone understands when to take blood pressure medication to achieve the best effect.

When to take blood pressure medication is a very noticeable issue for people who are being treated for a chronic disease: Hypertension . Taking blood pressure medication at night before bed instead of in the morning can make it more effective.
Many people have a habit of taking medicine as part of the morning, the medicine is taken at the time of sipping a cup of coffee and reading the daily newspaper. However, taking blood pressure medication at night may be a better option.
A large study of taking blood pressure medication all the time has found that: Taking a blood pressure medication at night before bed may lower your risk of serious heart-related complications more than taking it. in the morning.
Dr Naomi Fisher, director of the hypertension clinic at Brigham and Women's Hospital, affiliated with Harvard, said: "Heart attacks and strokes often occur earlier in the morning than at other times of the day. day. This may be related to the natural surge of certain hormones just before a person wakes up. Therefore, taking blood pressure medication at night before bed will lead to the highest drug concentrations and to lower blood pressure during times of high cardiovascular risk."

An October 22, 2019 study published in the European Heart Journal found that people who took their blood pressure medication at night were less likely to have a heart attack or stroke than those who took their medication in the morning. Here is a summary of the study:
Study subjects: the study was conducted on 19,084 adults in Spain with high blood pressure, with an average age of about 60. All were taking at least one medication. blood pressure.
How it's done: Participants were randomly assigned to take all of their blood pressure medications just once per day, either immediately upon waking or just before going to bed.
During an average follow-up of 6.3 years, the researchers checked the participants' blood pressure multiple times. In addition, at least once a year, participants will wear a portable blood pressure monitor that records blood pressure readings continuously for a period of 2 days. The researchers also tracked rates of cardiovascular problems such as heart attacks and strokes.
Results showed: Compared with those who took their medication in the morning, those who followed the night-time dosing regimen had better blood pressure control. Besides, the group of subjects who took the drug before going to bed also showed the following results
34% reduction in the chance of having a heart attack; 40% less likely to need an interventional procedure to restore blood flow to the heart (angioplasty or bypass surgery); 49% less likely to have a stroke; 42% less likely to have heart failure.

In most people, blood pressure tends to drop at night. But after about age 55, some people don't experience that nighttime "drop in blood pressure." These people may get the most benefit from taking their blood pressure medication at night.
Dr. Fisher notes that there are other potential advantages affecting when to take blood pressure medication. In clinical practice, some blood pressure drugs have the ability to significantly reduce blood pressure immediately after use.
Therefore, doctors recommend that people take these drugs at night to avoid a possible fall if a patient suddenly feels dizzy due to a low blood pressure.
Some drugs have a sedative effect when taken at night, which will help patients fall asleep more easily. However, diuretics used to treat high blood pressure will increase the frequency of urination, so they should not be used at night because they can cause patients to go to the bathroom constantly leading to insomnia.

Dr. Fisher takes a personalized approach when treating his patients. Some patients receive 24-hour ambulatory blood pressure monitoring, with automated equipment installed to measure blood pressure every 30 to 60 minutes throughout the day and night and record the results. Others simply check their blood pressure with a home monitor both morning and evening, a few days a week or so.
Physicians will use these values ​​to personalize dosing recommendations for each patient. For people who take multiple medications, Dr. Fisher usually recommends taking at least one medication at night.
In general, there is no risk if the patient decides to take their own blood pressure medication at night, but to ensure the best results from the medication being taken, the patient should discuss the timing. When to take your blood pressure medication with your treating doctor.

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Reference source: health.harvard.edu