Better to take blook pressure medications in the evening

[question everything]

I once read in the AARP publication that it is better to take the medicine in the evening, before bedtime.

But we visited my spouse's cardiologist who had no preferences. Spouse takes them in the morning.

So I found this article

After an average of 5½ years, study participants who took at least one blood pressure medicine at night had better blood pressure control. They also were about one-third as likely to have a heart attack or stroke or to develop heart failure, as those who took morning pills.

In most people, blood pressure begins to rise just before getting out of bed in the morning, and reaches its peak around mid-day. It falls during sleep, reaching its lowest point of day between midnight and 3:00 or 4:00 am. This drop is sometimes called “dipping.” But people with high blood pressure often have little or no decrease in their blood pressure at night. One possible reason for this is blood pressure medicines taken around breakfast time have worn off.

https://www.health.harvard.edu/blog/taking-blood-pressure-pills-at-bedtime-may-prevent-more-heart-attacks-strokes-201110253668

Anyone knows anything?

[GP6971]

1. My cardiologist

recommends anytime is good. Just be consistent about the time as the pill is time released.

[CaliforniaPeggy]

2. I take mine both in the morning and in the evening. BTW, these are different medications.

And my BP is well controlled.

[dixiegrrrrl]

10. I take the same BP med every 12 hours, no problem.

Might be different for people only taking once a day...dunno.

[MichMan]

3. Wouldn't the medication be at it's lowest when blood pressure was highest then?

Using that logic, if it was taken in the evening, wouldn't it start to wear off around mid day when blood pressure is at it's peak?

[question everything]

4. Perhaps you have an early start. Meaning, you start the day with low pressure

so that at its peak it will be lower.

[still_one]

5. Some of this is based on the fact that a subset of the population have spikes in BP during sleep.

The only way to determine if an individual is in that category is by Ambulatory blood pressure through a monitor which is worn for 24 hours to monitor the patients BP throughout the day and night.

It is also noted that some BP meds are can be taken twice a day, because it has been observed that the BP lowering effect of those meds may diminish near the end of the day, and in those cases it evens out the BP readings throughout the day.

There are some medications which probably should not be taken at night. Diuretics are one class of medications

It would be advisable to consult with one's physician, and discuss the article in question before taking the BP meds at night on your own.

Also notice that the article says to take at least one BP med at night, which implies that the patient is on multiple BP meds, and that may makes sense, but it would also be important to insure that your BP was well controlled during the day and night also

[question everything]

6. Thank you for the detailed explanation

this makes sense.

[JayhawkSD]

7. Blanket instructions are nonsensical.

Hospital nurses went berserk telling me to take statin (very low dose, 10 mg) at night and never in the morning. I started taking it at night and found myself suffering from muscle pain. Not terrible, but uncomfortable. Went back to taking it in the morning and the muscle pain disappeared entirely. It controls cholesterol very effectively.

[still_one]

8. Probably ok, but hopefully they ordered lab work for creatine kinase, creatinine, and transaminases

just to make sure

[question everything]

11. Intersting. Statin are supposed to be taking in the evening to, I think, prevent

muscle pain.

But as with everything we put into our bodies - meds, food - each reaction is different.

[eppur_se_muova]

9. My prescription says to take in evening ...

my doctor added that because I complained about side effects (postural hypotension) with lisinopril. Here's a little discussion, which suggest that *other than side effects*, time of day does not really matter: https://www.pharmacistanswers.com/questions/taking-lisinopril-morning-vs-night-which-is-better

The other effects in the article you cite may be due to the shorter persistence of older medications. See the link for fuller discussion.