Is Taking Blood Pressure Medication At Night Better?

Understanding blood pressure

The force that moves blood through the circulating system is termed blood pressure. It is important to move oxygenated blood (from the heart to the body) or deoxygenated blood (from the body to the heart) in the body. Blood pressure is measured in mm Hg (millimetres of mercury).

Blood pressure is measured in two figures: systolic (upper) and diastolic (lower)  blood pressure. Systolic blood pressure measures the pressure in arteries when the heart beats, and diastolic blood pressure measures the pressure in arteries when the heart rests between beats.¹

Signs and symptoms

High blood pressure is generally a silent killer. Most people won’t experience any symptoms. It may take decades to show symptoms. It is essential to measure blood pressure regularly.³

Symptoms of high blood pressure include:

• Headaches
• Nosebleeds
• Irregular heart rhythms
• Vision changes
• Buzzing in the ears
• Fatigue
• Nausea
• Vomiting
• Confusion
• Anxiety
• Chest pain
• Muscle tremors 

Causes and risk factors

Two types of risk factors cause blood pressure, which includes:

• Modifiable risk factors include unhealthy diets, i.e. excessive salt consumption, high saturated fat and trans fats in the diet, low intake of vegetables and fruits, no physical activity, consumption of alcohol, smoking, and obesity

• Non-modifiable risk factors include genetics (family history of hypertension), age over 65 years, and co-existing diseases such as diabetes or kidney disease 

Stages of high blood pressure

Diagnosis

Blood pressure must be checked regularly for days or weeks to know if someone has hypertension. The doctor will probably weigh and measure the patient. He or she might perform urine. Alternatively, blood tests were conducted to assess the presence of other conditions that may contribute to hypertension.

Some people have "white coat hypertension." This means that blood pressure goes up at a doctor's office because the patient gets nervous. When patients feel more relaxed, their blood pressure usually gets normal.4

When to contact a doctor?

Call the doctor for immediate medical care if:

Your blood pressure is much higher than normal, such as 180/120 mm Hg or higher or if you observe any symptoms of high blood pressure (mentioned in the symptoms section). 

Is it better to take blood pressure medicine at night? 

The best time to take blood pressure medicine

It has always been recommended to take antihypertensive (medication for high blood pressure) in the morning. The majority of blood pressure drugs, however, appear to work better when taken at night, according to mounting research.

This is primarily because of a theory known as chronotherapy. It is a method of scheduling medical care that is based on circadian rhythms, the body's natural 24-hour cycle of physical changes.6 Other medical diseases, including sleep apnea, chronic kidney/renal disease, and diabetes, have also benefited from using this method to determine the ideal times of day to provide treatment.

A trial known as the Hygia chronotherapy trial for evaluation of the time for taking blood pressure medications, published in the European Heart Journal, was conducted for an average of more than six years. 

Scientists examined over 19,000 individuals who had elevated blood pressure. They discovered that those who took their blood pressure medication at bedtime had a nearly 50% lower risk of experiencing a heart attack, stroke, or other cardiovascular events as compared to those who took their medication in the morning.5 

The results could be seen as a "practice-changing" step. It is a free, risk-free, and side-effect-free intervention that could be implemented universally after judging the risk factors. Just switching to an evening schedule might result in significant drops in cardiovascular events overall.

Supporting this theory is also the natural variation of blood pressure, which shows that it has a daily rhythm. The natural cycle is for it to fall at night and rise in the morning. Then, by afternoon, it begins to decline once more. This biological cycle helps to explain why taking blood pressure medication at night may be more effective.

When is not the best time to take blood pressure medicine? 

In the morning, a significant cardiovascular event, such as a heart attack or stroke, was 45% less likely to occur in those who took their blood pressure drugs at bedtime than in those who took them in the morning.7,8

Is it more effective at night than at other times? 

• According to recent studies, taking your blood pressure medicine before night may help significantly lower your chance of getting sick or dying from heart and blood vessel disease
• According to specialists, every drug regimen should be tailored for you based on a conversation with your doctor rather than taking a general approach

In the study, 19,084 individuals with high blood pressure were monitored for a median of 6 years.5

Two groups of patients—those who took their blood pressure medicine in the morning and those who took it at night—were observed for blood pressure changes. The researchers discovered that the patient's blood pressure was better at night after taking their medicine before bed.

Summary

Usually, symptoms of high blood pressure do not appear until a person experiences difficulties, including a heart attack or stroke.

If a person has high blood pressure, they may need to modify their lifestyle and take medicine to lower their blood pressure. If the actions someone is taking to lower their blood pressure are ineffective, they should speak with their doctor. Anyone who experiences hypertensive emergency symptoms should seek immediate medical attention.

Antihypertensive medications should be taken regularly and as prescribed by your Physician for effective management of this condition. Many recent studies have highlighted the benefits of taking blood pressure medicines at bedtime and have shown that the risk of further heart events like heart attacks and strokes is significantly reduced by following this routine. However, any change in your medication routine should be done after consultation with your treating doctor.