Core tip: people who take antihypertensive drugs all year round have a problem with medication time. Generally speaking, clinicians recommend hypertensive patients to take antihypertensive drugs in the morning. Many people think that the medication time suitable for hypertensive patients is fixed. All hypertensive patients can get the best antihypertensive effect by taking antihypertensive drugs in the morning, but this is not the case.
People who take antihypertensive drugs all year round have a problem. Generally speaking, clinicians recommend hypertensive patients to take antihypertensive drugs in the morning. Many people think that the medication time suitable for hypertensive patients is fixed. All hypertensive patients can get the best antihypertensive effect by taking antihypertensive drugs in the morning, but this is not the case.
The optimal time of taking antihypertensive drugs is affected by the 24-hour change of blood pressure, drug mechanism, and other factors. Different people, different kinds of antihypertensive drugs, the best time to take antihypertensive drugs is not the same.
Influencing factors of the best time of medication in patients with hypertension
1. 24-hour change of blood pressure in patients
The blood pressure curve of healthy people in a day is spoon-shaped. There are two peaks in the blood pressure of healthy people in a day, which are from 6:00 to 10:00 in the morning and from 4:00 to 8:00 in the afternoon. The blood pressure of other periods is relatively low, and the blood pressure reaches the trough after entering sleep at night.
For patients with hypertension, if the blood pressure fluctuation is still a normal spoon curve, and the two blood pressure peaks are concentrated in the daytime, antihypertensive drugs should be taken in the daytime. Generally, the best effect is 1-2 hours before the peak blood pressure. If the patient's blood pressure is high at night, it is recommended to take medication before going to bed at night.
To make clear their blood pressure changes, hypertensive patients can regularly do 24-hour blood pressure monitoring, to understand their blood pressure changes in a day, according to the blood pressure changes, to determine the best medication time.
This can not only avoid the peak effect of antihypertensive drugs and the peak blood pressure of patients with hypertension but also avoid the situation of limb blood perfusion insufficiency caused by blind medication at night.
2. Mechanism of antihypertensive drugs
The mechanism of action of antihypertensive drugs is another major factor determining the optimal time of taking antihypertensive drugs. One of the most obvious examples is diuretics, which are not suitable for taking at night. Diuretics are mainly used in patients with hypertension who have * fluid retention. By promoting urination, they can reduce the sodium content in the body, thereby lowering blood pressure.
Taking diuretics at night will lead to an increase of nocturia, thus affecting the quality of sleep. Besides, taking diuretics at night also increases blood viscosity and the risk of cardiovascular disease.
According to the time of drug action, antihypertensive drugs can be divided into long-term antihypertensive drugs, medium effect antihypertensive drugs, and short effect antihypertensive drugs. According to the time of drug action, the frequency and time of taking antihypertensive drugs are also different.
For example, long-acting antihypertensive drugs are usually taken once a day and can be taken 1-2 hours before the peak of blood pressure according to the fluctuation of blood pressure.
Take the medium effect antihypertensive drugs twice a day, and patients can take them once every 1-2 hours before two blood pressure peaks in a day.
Short-acting antihypertensive drugs can be taken three times, once 1-2 hours before two blood pressure peaks, and once before 18 PM to control night blood pressure.
Taking antihypertensive drugs at night may be the best time
An interesting phenomenon is that although doctors usually recommend hypertensive patients to take antihypertensive drugs in the morning, the experimental results support patients to take antihypertensive drugs at night.
The results of 40 randomized controlled trials involving 44167 samples from the European cardiovascular society showed that taking antihypertensive drugs at night can significantly reduce 24-hour mean systolic and diastolic blood pressure; taking antihypertensive drugs at night can better control blood pressure than taking antihypertensive drugs after getting up in the morning; and compared with taking antihypertensive drugs after getting up in the morning, taking antihypertensive drugs at night can reduce the risk of cardiovascular adverse events by 52%.
Suggestions for hypertensive patients are as follows:
1. Do 24-hour blood pressure monitoring to understand their blood pressure changes;
2. When taking medicine, consult the attending doctor about the best time of taking medicine according to the change of blood pressure.
