No Mention Of Timing In Current Guidelines
Prof. Hermida explains that the current guidelines on how to treat high blood pressure do not mention or give advice about the best time of day to take the pills.
Morning ingestion has been the most common recommendation by physicians, based on the misleading goal of reducing morning blood pressure levels, he observes.
However, previous findings from the Hygia project have shown that the most significant independent marker of peoples cardiovascular risk is their average systolic blood pressure during sleep.
This link is independent of blood pressure readings taken during waking hours or at visits to the doctor, notes Prof. Hermida.
Furthermore, he adds, there are no studies showing that treating hypertension in the morning improves the reduction in the risk of cardiovascular disease.
A limitation that he and his colleagues highlight is that, because the participants came from one ethnic group, they cannot say how true the findings might be for other populations.
Paul Leeson, Ph.D., a professor of cardiovascular medicine at the University of Oxford, in the United Kingdom, was not involved in the trial.
He commends the findings and describes the scale, length of follow-up, and effect size as impressive.
Where the benefit comes from remains unclear, Prof. Leeson observes.
Do these effects arise because the drugs improve sleep patterns or because side effects present less of a problem at night? he muses.
High Blood Pressure Medications
Treating high blood pressure will help prevent problems such as heart disease, stroke, loss of eyesight, chronic kidney disease, and other blood vessel diseases.
You may need to take medicines to lower your blood pressure if lifestyle changes are not enough to bring your blood pressure to the target level.
WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED
Most of the time, your health care provider will try lifestyle changes first and check your BP two or more times.
If your blood pressure is 120/80 to 129/80 mm Hg, you have elevated blood pressure.
- Your provider will recommend lifestyle changes to bring your blood pressure down to a normal range.
- Medicines are rarely used at this stage.
If your blood pressure is equal to or higher than 130/80 but lower than 140/90 mm Hg, you have Stage 1 high blood pressure. When thinking about the best treatment, you and your provider must consider:
- If you have no other diseases or risk factors, your provider may recommend lifestyle changes and repeat the measurements after a few months.
- If your blood pressure remains equal to or higher than 130/80 but lower than 140/90 mm Hg, your provider may recommend medicines to treat high blood pressure.
- If you have other diseases or risk factors, your provider may be more likely to recommend medicines at the same time as lifestyle changes.
MEDICINES FOR HIGH BLOOD PRESSURE
Most of the time, only a single drug will be used at first. Two drugs may be started if you have stage 2 high blood pressure.
Follow The Other Parts Of Your High Blood Pressure Treatment Plan
When it comes to treating high blood pressure, it’s likely that you and your doctor have talked about steps in addition to taking medication. These steps can help make your medicine work even better to control blood pressure. Here are some of the other steps that might be part of your plan:
- Eat a diet that includes lots of fruits, vegetables, and low-fat meat and dairy foods.
- Watch how much sodium you eat in your diet. Most of the sodium you eat comes from packaged or processed foods.
- Watch how much alcohol you drink. Ask your doctor about an appropriate amount.
- Don’t use cigarettes or other tobacco products.
- Get as close as you can to a healthy weight. Your doctor can help you determine an appropriate goal.
- Get regular physical activity. Try for 150 minutes of moderate activity a week.
- Learn ways to relieve stress, such as relaxation techniques.
For each of these steps, your doctor can give you more information and get you started. Or your doctor may refer you to other health professionals who can help. Some health centers even offer free or inexpensive classes in these areas.
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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.
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What Time Should You Take Blood Pressure Medication
Although simple lifestyle changes can help reduce blood pressure, you may also need to take medication. Your doctor might advise you to take medicine depending on your blood pressure readings and whether you are at risk of developing conditions such as a stroke or heart attack.
In cases where your blood pressure remains above 140/90mm Hg over a considerable time, a health expert may offer you medicine to help lower your blood pressure, especially if you are at risk of other health problems.
If youre prescribed medication, you may wonder when is the best time to take it. Some people prefer taking their medicine in the morning while others take it at bedtime. This article will take a deep dive into the ideal time to take high blood pressure medication.
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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.
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Cdc Facts Percent Of People Who Will Continue To Take Blood Pressure Medication
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When Treatment Is Recommended
Everyone with high blood pressure is advised to make healthy lifestyle changes.
Whether medicine is also recommended depends on your blood pressure reading and your risk of developing problems such as heart attacks or strokes.
Your doctor will carry out some blood and urine tests, and ask questions about your health to determine your risk of other problems:
- if your blood pressure is consistently above 140/90mmHg , but your risk of other problems is low you’ll be advised to make some changes to your lifestyle
- if your blood pressure is consistently above 140/90mmHg and your risk of other problems is high you’ll be offered medicine to lower your blood pressure, in addition to lifestyle changes
- if your blood pressure is consistently above 160/100mmHg you’ll be offered medicine to lower your blood pressure, in addition to lifestyle changes
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One Reader Shares His Story:
Sometimes an anecdote reveals the science:
Q. I want to thank you for your story about whether to take blood pressure medications in the morning or at bedtime. Ive been taking BP meds for about 20 years.
In January I visited my doctor about another problem, and he became concerned about my blood pressure. He wanted me to monitor it every day for a month and check back in.
During that month, I read your article. Id been taking my meds with breakfast and I decided to change that.
The effect was quite remarkable. My systolic pressure dropped from about 145 to 135.
Ive had serious side effects from BP meds in the past and I was apprehensive that my doctor would change my meds. Lately, Ive been on amlodipine and HCTZ and the side effects seem minimal. Yesterday, my doctor decided to not to make any changes and I want to thank you for that.
A. We are glad to hear that this is working for you. Research shows that people taking their blood pressure pills in the evening had better BP control and were less likely to have heart attacks or strokes .
Why Is The Timing Of Your Medication Important
According to AARP, blood pressure follows a daily rhythm. It rises higher during the day and falls at night when we sleep.
Since morning blood pressure is usually highest, people often opt to take their medications then. Many also feel that it is easier to remember morning medications.
Also, since many medications cause urination, people may prefer to take them early in the day.
As we age, however, we may develop a blood pressure pattern called non-dipping. Non-dipping blood pressure tends to remain high overnight.
People ages 55 and older with high blood pressure are more prone to non-dipping.
Non-dipping blood pressure is a problem because it is a major risk factor for several conditions, including heart attack, stroke, and kidney disease.
Overnight blood pressure control is important in order to lower your risk.
If your medication wears off before your next dose is due, your blood pressure may be elevated for several hours while you sleep. You may also wake with high blood pressure.
Taking your medication at bedtime may help prevent this issue.
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To 129/less Than : You Probably Don’t Need Medication
Your blood pressure is higher than you want, but it’s not full-on high blood pressure. Unless you also have another health condition — like kidney disease or heart problems — your doctor will likely say you don’t need drugs for now.
But don’t ignore it. You’re on the path to high blood pressure, so make some changes to your lifestyle. Cut down on salt and alcohol, get more exercise, and drop pounds if you’re overweight.
Updates On When To Take Your Bp Pills:
An analysis of 153 studies carried out over 45 years confirmed the Spanish research results . The researchers reported that when hypertension medications were taken at bedtime/evening rather than upon-waking/morning there were fewer adverse drug reactions and better kidney function.
A recent review of 155 randomized controlled trials compared people taking their medicines in the morning or in the evening . A significant majority of these trials found better blood pressure control when people took their pills at bedtime. None of them found that taking the pills in the morning worked better.
Diuretics could be an exception, though. Taking such water pills in the evening might lead to excessive urination during the night. In addition, people with glaucoma must take their blood pressure pills in the morning. Keep reading to learn more.
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Can I Change The Time I Take My Blood Pressure Medication
You can’t just start taking your medication at nighttime because different medicines work in different ways.
For example, diuretics lower blood pressure by causing you to urinate out extra fluids. If you take a diuretic at ten o’clock in the evening, you might have to get up four hours later to go to the bathroom. A disruption to your sleep pattern could have negative health effects that may counterbalance the beneficial effect of the medication.
Beta-blockers are another group of blood pressure-lowering medications that reduce your heart rate. Since your heart rate typically goes down at night as you relax, taking beta-blockers at bedtime could cause your heart to beat too slowly. Therefore, it might be better to take these medicines in the morning when your heart rate is likely to be higher.
If you are experiencing side effects of blood pressure medications during the day after taking specific medications in the morning, you can move them to bedtime.
For instance, amlodipine, which is commonly prescribed, works by dilating arteries, thereby reducing blood pressure and making it easier for your heart to pump blood. This medication doesn’t affect your heart rate and doesn’t make you urinate, so you can take it at bedtime.
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?
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What Else Do I Need To Know
- Do not take a BP reading in an arm that is injured or has an IV or shunt.
- Take your BP medicines as directed. Do not stop taking your medicines if your BP is at your goal. A BP at your goal means your medicine is working correctly.
- Bring the BP machine to your follow-up visit. Your healthcare provider can check that you are using it correctly.
At Home With A Monitor
Home monitoring can be a great way to keep track of your blood pressure on a daily basis.
With home monitoring, you can check your blood pressure throughout the day and at times that are convenient for you. It can help you see how your blood pressure changes throughout the day and help you get a sense of your average blood pressure range.
However, youll need to purchase a blood pressure monitor to do this. Youll also need to learn how to use it and how to record accurate readings.
Its not complicated to learn the basics of many home monitors, but it can still be easy to make a mistake.
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