When to start blood pressure medication
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
you
