When should you take your blood pressure medicine?

my name is Luke laughing and I'm a

preventative cardiologist here at the

Cleveland Clinic I also specialize in

the management of difficult to control

blood pressure or resistant hypertension

I'm getting a lot of questions these

days about when it's the best time to

take your blood pressure medicines now

this is a particularly important point

because there was a large study produced

from Spain at the end of 2019 looking

and saying that we decrease our risk of

cardiovascular events if we take our

blood pressure medicines at night now

there's been multiple studies before

this that didn't show such an effect so

we're still waiting for these results to

be replicated however I think that it

does bring up some important points

about when I tell patients to take their

blood pressure medicines first and

foremost if you're taking diuretics so

water pills it's best to take those

earlier in the day one thing that we

know contributes to adverse

cardiovascular outcomes is poor sleep so

I don't want my patients getting up in

the middle of the night to urinate and

if we're taking our diuretics right

before we go to bed we do risk that

happening what I'll often times

recommend to individuals is if you're

taking medications and such as beta

blockers or calcium channel blockers or

blockers of the Rena and angiotensin

system like ACE inhibitors or

angiotensin receptor blockers I think

it's very reasonable to take those in

the evening and oftentimes I'll tell my

patients to do that the main reason for

that is most of these medicines work for

24 hours but we know they're going to

have their peak effect about 2 to 3

hours after we take them so taking them

at night helps keep blood pressure low

at night also helps to avoid any side

effects from blood pressure going too

low when they're having their peak

effect now irrespective of all this I

think it's important to understand that

because most of these medicines do last

over 24 hours it probably doesn't make a

huge difference when you take them in

terms of efficacy and controlling blood

pressure the biggest factor that we have

to remember is take them

patient adherence and medication

adherence is very important and that

leads to better cardiovascular outcomes