How to Master the Correct Time to Take Your Antihypertensive Drugs

 

Many people with high blood pressure find it hard to control their blood pressure even with medication. This may not be due to the medication itself, but rather to the patient's medication habits. If you take your medication at the wrong time, it may not help lower your blood pressure effectively.

To master the correct time to take your medication, you first need to understand your own blood pressure pattern.

For most people, blood pressure has a "high during the day, low at night, two peaks and one valley" rhythm phenomenon in 24 hours: that is, 8:00-9:00, 16:00-18:00 are the highest; during night sleep, blood pressure drops, and reaches the lowest point between 0:00 and 3:00 in the morning. The blood pressure curve in a day looks like a spoon, called spoon-shaped blood pressure. According to this rule, if you synchronize the onset time of antihypertensive drugs with the peak period of blood pressure fluctuations, you can make the drugs have a better antihypertensive effect. Specifically, for patients with spoon-shaped blood pressure, they should follow these points:

1. Long-acting antihypertensive drugs that are taken once a day (including controlled-release tablets and sustained-release tablets), such as amlodipine, nifedipine controlled-release tablets, metoprolol sustained-release tablets, perindopril, valsartan, losartan, fosinopril, benazepril, etc., are mostly taken at 7:00 in the morning. They can be taken before or after meals, but it is recommended to take them before eating.
2. Medium-acting antihypertensive drugs that are taken twice a day, such as nifedipine sustained-release tablets, enalapril, felodipine (Plendil), metoprolol, etc., are best taken at 7:00 in the morning and 15:00 in the afternoon.
3. Short-acting antihypertensive drugs that are taken three times a day, such as nifedipine tablets and captopril tablets. The first time is taken when you wake up in the morning, the second time is at 13:00 noon, and the last time is before 18:00 in the afternoon.
4. It should also be reminded that patients with spoon-shaped blood pressure should never take antihypertensive drugs before going to bed or at night to avoid low blood pressure leading to insufficient tissue perfusion and thus inducing ischemic stroke. In addition, diuretics such as hydrochlorothiazide should be taken in the morning to avoid taking them at night causing an increase in nocturia and affecting sleep.

In addition, some patients have atypical blood pressure fluctuations. The nocturnal blood pressure drop is less than 10% compared with daytime. This is called non-spoon-shaped blood pressure. There are even fewer patients who have no nocturnal blood pressure drop or even exceed daytime levels. This is called reverse spoon-shaped blood pressure. Generally speaking, patients with non-spoon-shaped or reverse spoon-shaped blood pressure often indicate persistent sympathetic nerve excitement, causing nocturnal blood pressure to remain high. This can cause damage to the brain, heart, kidneys and large blood vessels. Therefore, close control of nocturnal blood pressure is required. Such patients need to use long-acting antihypertensive drugs and should take them at 8 pm or before going to bed.

Patients should do a 24-hour blood pressure monitoring and determine the medication time according to their blood pressure fluctuation type. Generally choose to take medication 1-2 hours before the peak. Patients can also choose four time points in a day and measure their blood pressure every six hours for three consecutive days. This way they can roughly grasp their own blood pressure fluctuations and infer the appropriate medication time from this.

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