What The Nhs Has To Say On What Time Of Day You Should Take Your Blood Pressure Tablets
They’ve given their reaction to a new study on when is best to take the medication
- 05:00, 28 OCT 2019
The NHS has weighed in on whether blood pressure medication should be taken close to bedtime.
It comes after a new study conducted by several institutions in Spain suggested that tablets for high blood pressure were significantly more effective when taken at night.
The research, which was funded by the Spanish government, involved around 20,000 participants whose usage of tablets for the condition was monitored during a six-year follow-up period.
The findings of the study suggested that there’s almost a 50% less chance of suffering a heart attack or stroke if the tablets are taken at night, with the results having since become the subject of international media attention.
But now the NHS has on the new research, explaining its thoughts on whether blood pressure tablets should be part of patient’s night-time routine.
Healthfda Expands Blood Pressure Drug Recall Again
Previous studies had hinted that better blood pressure control at night might offer a benefit.
“This was the piece that was missing,” Dr. Renato Lopes, a professor of medicine at Duke University School of Medicine, said.
“For the first time in a very large, randomized fashion, this study really gave us impressive results,” said Lopes, who was not involved in the new research.
While the results are encouraging, researchers say patients with high blood pressure should speak with their doctors before making any changes to their blood pressure medication routines.
“It is important to understand that this may not apply to medications that need to be taken more than once a day, or for blood pressure medications that are being prescribed for other problems such as angina,” Dr. Tim Chico, professor of cardiovascular medicine at the University of Sheffield in the U.K., said in a statement.
And there are other caveats.
The new research had participants take all of their blood pressure medications at once, either at night or in the morning, rather some in the morning or some at night. But some cardiologists say many patients may need a more tailored approach.
“For most people, a combination of a couple medicines in the morning and a couple in the evening means you’re going to do better, eliminate side effects and generally have better control of your blood pressureover 24 hours,” Laffin said.
Make A List Of All Of Your High Blood Pressure Medications
Your doctor has many high blood pressure medications to choose from. They work in different ways to lower your blood pressure. Each type of drug has its own possible side effects, so it’s a good idea to know exactly which high blood pressure medicines you take. Ask your doctor or pharmacist these questions:
- What are the names of my high blood pressure drugs? Ask for both the brand name and the generic name.
- How does this medication help lower my blood pressure?
- What is the dose?
- How often do I take the medication?
Make a list of your high blood pressure drugs, and make a few copies of the list. Take the list with you whenever you visit a health care professional. Give copies to any family members or friends who help with your health care.
Read Also: How Does Alcohol Affect Blood Pressure
Taking Blood Pressure Pills At Bedtime Best For Cardiovascular Health
New research suggests that the best time for people with hypertension to take their blood pressure pills is at bedtime rather than in the morning.
Researchers came to these conclusions after analyzing data from the Hygia Chronotherapy Trial.
Hygia is the largest and longest lasting clinical trial to examine the effects of antihypertensive medication timing on the risk of cardiovascular events.
The investigators behind the present findings randomly assigned 19,084 adults to take the blood pressure pills that their doctors had prescribed either when they woke up in the morning or at bedtime. The participants were of Caucasian Spanish descent, and 8,470 were female.
During an average follow-up of 6 years, all individuals underwent 48-hour ambulatory blood pressure monitoring at least once per year.
The results of this study, says Ramón C. Hermida, Ph.D., the leader of the Hygia project, show that patients who routinely take their antihypertensive medication at bedtime, as opposed to when they wake up, have better-controlled blood pressure and, most importantly, a significantly decreased risk of death or illness from heart and blood vessel problems.
He and colleagues report the recent findings in the European Heart Journal.
Largest Study Finds Greater Reduction In Risk Of Cardiovascular Disease And Death From Bedtime Rather Than Morning Medication
- European Society of Cardiology
- People with high blood pressure who take all their anti-hypertensive medication in one go at bedtime have better controlled blood pressure and a significantly lower risk of death or illness caused by heart or blood vessel problems, compared to those who take their medication in the morning, according to new research.
People with high blood pressure who take all their anti-hypertensive medication in one go at bedtime have better controlled blood pressure and a significantly lower risk of death or illness caused by heart or blood vessel problems, compared to those who take their medication in the morning, according to new research.
The Hygia Chronotherapy Trial, which is published in the European Heart Journal today , is the largest to investigate the effect of the time of day when people take their anti-hypertensive medication on the risk of cardiovascular problems. It randomised 19,084 patients to taking their pills on waking or at bedtime, and it has followed them for the longest length of time — an average of more than six years — during which time the patients’ ambulatory blood pressure was checked over 48 hours at least once a year.
The researchers had adjusted their analyses to take account of factors that could affect the results, such as age, sex, type 2 diabetes, kidney disease, smoking and cholesterol levels.
Treatment of Hypertension During Sleep ,
Don’t Miss: Can High Blood Pressure Cause Swollen Ankles
Dr Roach: When Is The Best Time To Take Blood Pressure Meds
Dear Dr. Roach: I read on the internet that you should take your blood pressure medicine at night. I just recently started taking medicine for my blood pressure and my instructions were to take it first thing in the morning. So, when is the best time to take it?
Dear B.H.: A study published last October showed that, as a group, people who were told to take all their high blood pressure medicines at night had surprisingly fewer bad events than people who were told to take their medicines in the morning. Subjects in the study could be taking any of the major types of blood pressure medicines that are normally given once daily.
The reason those who took their medicines at night did so much better may be related to normal physiology. During sleep, the blood pressure normally dips down. In some people, there is a diminished dip or even the opposite occurs a rise in blood pressure. Taking blood pressure medicine at nighttime restored or enhanced the normal response. In addition, blood pressure normally rises around 6 in the morning, timed with an increase in the blood levels of the hormone cortisol. This is the peak time for heart attacks. Its possible that having protection from high blood pressure at this time from taking it at night could help prevent heart attacks. Thats opposed to those taking it during the day at 6 a.m., the medicine is wearing off and protection is at its lowest.
What Does Current Guidance Say On This Issue
NICE hypertension guidelines cover the diagnosis of the condition and assessment of cardiovascular risk. Recommendations are given on starting antihypertensive medication alongside lifestyle adjustment, stepwise selection of drug treatment, and ongoing monitoring.
No recommendations are given on the timing of drug administration.
Recommended Reading: How To Know If You Have Low Blood Pressure
When Should You Take Your Blood Pressure Medication
Luke Laffin, MD, is a preventive cardiologist and Medical Director of Cardiac Rehabilitation in the Section of Preventive Cardiology, who specializes in difficult to treat blood pressure. Dr. Laffin addresses the question: When is the best time to take blood pressure medications?
When should you take your blood pressure medication?
What Factors Could Have Affected The Results Of The Outcomes And Were These Taken Into Account
The use of 24-hour ambulatory blood pressure monitoring throughout the study means that investigators had accurate measures of the effects of the different medication regimens on BP in the randomised groups. Poor adherence to treatment could have confounded the outcomes however, there was no difference in adherence between the groups.
Read Also: How To Beat High Blood Pressure
When Is The Best Time To Take Blood Pressure Medication
One out of three American adults has high blood pressure, equating to roughly 75 million people. When you take into account health care services, medications and work absences, the cost of this disease is more than $46 billion annually, according to information from the Centers for Disease Control.
High blood pressure places you at a greater risk for heart attacks or strokes, and yet it is known as the silent killer because there are often no noticeable symptoms. In addition to diet and lifestyle changes, medication can help reduce your blood pressure and your risk of complications such as kidney damage, stroke and heart damage.
However, its very important that you speak to one of our general practitioners in Raleigh about what time you should take your blood pressure medications.
How Blood Pressure Medication Works
There are 11 categories of blood pressure medication. Each works in different ways, with the overall goal of lowering the pressure in the blood vessels and sometimes also reducing the work that the heart has to do.
- Diureticsflush excess fluid and sodium out of the body to reduce blood volume and pressure in the blood vessels.
- Beta-blockersmake the heart beat more slowly. They reduce how hard it has to work.
- ACE inhibitorshelp to reduce the amount of a hormone called angiotensin. This hormone causes arteries to narrow.
- Angiotensin II receptor blockers block the receptors for angiotensin to prevent it from narrowing arteries.
- Calcium channel blockersrelax and dilate blood vessels, decreasing pressure in the vessels. They also lower the heart rate.
- Alpha-blockershelp to relax the walls of blood vessels.
- Alpha-2 receptor agonists lower the activity of the sympathetic nervous system. This is a part of the nervous system that controls heart rate and other involuntary body functions.
- Combined alpha- and beta-blockers are used for the treatment of heart failure they are sometimes prescribed for treating a hypertensive crisis.
- Central agonists make it harder for blood vessels to contract .
- Peripheral adrenergic inhibitors block chemicals in the brain that play a role in causing blood vessels to become narrow.
- Vasodilatorsrelax the walls of blood vessels. This helps them to widen and lowers blood pressure.
Don’t Miss: What To Take For Low Blood Pressure
When Is The Best Time Of Day To Take Blood Pressure Medication
People diagnosed with high blood pressure tend to take their medication in the morning. Since your heart rate and blood pressure are usually higher when waking up and lower when you sleep, this timing seems to make sense.
However, current research is increasingly pointing toward taking these medicines at bedtime. This is especially true from the angle of chronotherapy, an approach based on your body’s natural cycle of physical changes every 24 hours, referred to as your circadian rhythm.
Health experts have also used this approach to determine the best timing to effectively treat other conditions like diabetes, chronic kidney disease, and sleep apnea.
A new study in Spain also suggests that taking high blood pressure medication at night is more effective than in the morning. The HYGIA chronotherapy trial³ included 19,168 patients aged 60 or older. Half of the patients took blood pressure medicines before bedtime the other half when they woke up.
Results showed that those who took medicines before bedtime controlled their blood pressure level better than those who took them at the other end of the day. They also had a 45% lower risk of heart-related illnesses or death.
A close assessment showed that taking medication at night reduced the risk of:
Heart attack by 44%
Heart failure by 42%
This is the longest, largest trial examining the effects of different timings of antihypertensive medication on the possible risks of heart disease.
Bedtime May Be Best Time For Blood Pressure Meds
By Alan Mozes HealthDay Reporter
WEDNESDAY, Oct. 23, 2019 — Taking blood pressure medications at bedtime rather than in the morning nearly halves the risk of dying from a heart attack, stroke or heart failure, a large, new study finds.
Researchers in Spain followed more than 19,000 adults with high blood pressure. They found that people who took all their blood pressure meds at night had lower blood pressure around the clock compared to volunteers who took their medication in the morning.
Hermida is director of bioengineering and chronobiology at the University of Vigo’s Atlantic Research Center for Information and Communication Technologies.
“Conventionally, most patients ingest their medication in the morning,” said Hermida, “although no single trial ever documented this to be preferable.” No guidelines are currently in place regarding the best time to take the drugs, he added.
A New York City heart doctor believes consistency in taking your blood pressure pills will deliver optimal protection.
“The key here is routines,” said Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital. “Not missing a dose. We know one thing worse than an elevated blood pressure is swings in blood pressure due to periodic non-compliance.”
European Heart Journal
Recommended Reading: Is Coffee Bad For Blood Pressure
Causes And Risk Factors
You may be at an increased risk for high blood pressure if you smoke, areoverweight, eat a diet thats low on produce and fiber and/or high in fatand salt, drink alcohol to excess, live with chronic stress or dont getmuch physical activity. Some causes of hypertension cannot becontrolledincluding your genes and your race . Aging also plays a role. Even if you do not have hypertensionby age 55 to 65, your lifetime risk for developing it is a whopping 90percent.
But doctors no longer consider hypertension inevitable or untreatable withage, saysSamuel Durso, M.D., director of the Division of Geriatric Medicine and Gerontology at JohnsHopkins.
In one Johns Hopkins study of 975 older women and men with hypertension,healthy lifestyle steps helped 40 percent stop taking blood pressuremedications. Other research has shown that lifestyle changes can lower therisk for hypertension in African-Americans and others at an increasedgenetic risk.
What Specific Findings Did The Study Make
Having accounted for age, sex, smoking, history of cardiovascular complications and a natural decrease in blood pressure during sleep, the research team discovered that participants who used blood pressure medication at night-time were 56% less likely to die from cardiovascular disease, 49% less likely to experience stroke and 44% less likely to have a heart attack, in comparison with the group who took treatment upon waking.
Not only does taking blood pressure treatment before bed reduce serious risk factors, it bolsters blood pressure control. Participants had better sleeping blood pressure profiles and lipid profiles in the randomised trial.
You May Like: Blood Pressure When Lying Down
Why Taking Blood Pressure Meds At Bedtime May Be More Effective
- New research suggests that taking your blood pressure medication at bedtime may more effectively reduce your risk of illness or death due to heart and blood vessel disease.
- Timing of medication is important because blood pressure follows a daily rhythm. It rises higher during the day and falls at night when we sleep.
- Rather than taking a blanket approach, experts say any medication regimen should be personalized for you based on a discussion with your physician.
Should you be taking your blood pressure medication at bedtime rather than in the morning?
Research published in the October 22, 2019, issue of the European Heart Journal suggests that maybe you should.
In the study, the researchers followed 19,084 patients with high blood pressure for a median of 6 years.
The patients were randomly assigned to one of two groups: those who took their blood pressure medication in the morning and those who took it at bedtime.
The researchers found that bedtime medication seemed to make a difference for patients as they had better nighttime blood pressure.
They also had less risk of illness or death due to heart and blood vessel disease.
Take Your High Blood Pressure Drugs Exactly As Prescribed
High blood pressure drugs work best if you take them as your doctor has prescribed them. So you need to take the right amount at the right times every day. Ask your doctor or pharmacist these questions:
- How much of the medication should I take?
- How often should I take it?
- Are there special instructions, such as to take the drug with food?
- What should I do if I miss a dose?
Also Check: How To Lower Heart Rate And Blood Pressure