When should you start taking antihypertensive drugs

There are two questions here. The first one is, when should I start taking antihypertensive drugs for hypertension? The second question is, if I take antihypertensive drugs for a long time, when is the best time to take them every day?

1. When should I start taking antihypertensive drugs if I have high blood pressure?

First of all, I want to tell you that you don’t have to take antihypertensive drugs if you have high blood pressure. For newly discovered high blood pressure, if the blood pressure is not higher than 160/100, and there is no diabetes or complications of high blood pressure, such as heart failure, angina pectoris, myocardial infarction, renal failure, etc., then at this time, you can temporarily stop taking antihypertensive drugs and control your blood pressure through a healthy lifestyle, that is, a low-salt diet, quitting smoking and drinking, exercising regularly, controlling your weight, avoiding staying up late, etc. If the blood pressure can be reduce to 130/80 in 3 months, then you don’t need to take antihypertensive drugs and continue to live a healthy life and control your blood pressure.

If the blood pressure is still higher than 140/90 after 3 months, consider taking anti hypertensive drugs. This is the first situation for taking antihypertensive drugs.

Secondly, if high blood pressure is found to be higher than 160/100, or is complicate by diabetes, heart failure, myocardial infarction, renal failure, cerebrovascular disease, etc. Then anti hypertensive drugs must be take immediately to control blood pressure.

This is when you should start taking antihypertensive medication if you have high blood pressure.

2. What is the best time to take antihypertensive drugs every day?

1. It is recommended that you take long-acting antihypertensive drugs

Long-acting antihypertensive drugs are easy to take once a day and can keep blood pressure relatively stable. However, short-acting antihypertensive drugs not only need to be taken 2-4 times a day, but most importantly, can cause unstable blood pressure.

2. Most people take antihypertensive drugs in the morning

In theory, long-acting anti hypertensive drugs slowly release their effects over a long period of time, so they can be taken at any time. However, real cases tell us that for most people, anti hypertensive drugs are more effective when taken in the morning.

Our 24-hour blood pressure rhythm shows a double peak and double trough, that is, it rises from 6 to 10 am, drops from 2 to 3 pm, rises again from 4 to 6 pm, and then slowly drops to the lowest trough value at 2 to 3 am.

Most people have high blood pressure in the morning, which is call morning peak blood pressure . The morning peak phenomenon significantly increases the risk of cardiovascular and cerebrovascular events in patients with hypertension during the morning period . In other words, patients with poorly controlled morning blood pressure have a greatly increased risk of angina pectoris, or even myocardial infarction, stroke, and other malignant events.

Therefore, it is generally recommend that people with hypertension take antihypertensive drugs in the morning, so that their blood pressure can be basically control ideally and various cardiovascular and cerebrovascular emergencies in the morning can be prevent.

3. The latest research has new ideas

A randomized control study in the European Heart Journal that included 20,000 people and followed them for more than 6 years said that antihypertensive drugs may be best take before bed. The study found that taking medication before bed can reduce cardiovascular events by 45% compared with taking medication in the morning.

Of course, this is just one study and there is no conclusion yet. More evidence is need to determine whether it is necessary to take the drug before bed.

4. What should we do?

1) If you are currently taking anti hypertensive drugs and your blood pressure is stable, do not change and just take them at the same time as you are currently taking them.

2) If your blood pressure is unstable after taking anti hypertensive drugs, you can consult a professional doctor to analyze the reasons. If it is cause by inappropriate medication time, adjustments need to be made.

The ideal medication time should be individualize, and it is best to determine the medication time based on the 24-hour blood pressure curve. Especially for patients with poor blood pressure control, 24-hour dynamic blood pressure monitoring should be perform , and the doctor should adjust the medication time accordingly.

3) For blood pressure that is difficult to adjust, it is best to wear an ambulatory blood pressure monitor to observe blood pressure fluctuations and then adjust the medication regimen and time.

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Because each person’s specific situation is different, there is no uniform standard for the time to take antihypertensive drugs. The principle is that after taking antihypertensive drugs, blood pressure becomes more stable, so we take them at this time.

For most people, take long-acting antihypertensive drugs in the morning first, and make further adjustments if the effect is not good.

But more importantly, you have to monitor your blood pressure, otherwise how do you know if your blood pressure is stable?