Bedtime may be the best time to take HBP meds

[latexman]

bedtime-may-be-best-time-take-blood-pressure-meds

A couple summaries:

The differences in outcomes were striking: Compared with the group who took their pills in the morning, the nighttimers had a more than 40 percent lower risk of experiencing a heart attack, heart failure, stroke or needing procedures to open clogged coronary arteries.

What's more, their risk of dying from heart problems during the study period was cut by 66 percent.

I've been taking HBP meds for 20 years . . . in the mornings, according to Dr. instructions. I sent my Dr. an e-mail this morning!

I take a beta-blocker and a diuretic. I'm a little worried about taking the diuretic at bedtime. Don't want to have to get up to go to the bathroom, but the article and the study said even diuretics were taken at bedtime. Worth a try!

I also downloaded the European Health Journal article. Very interesting!

When do you take HBP meds? Does this article change your mind?

 

[Buckeye]

If he says to continue taking them in the morning, I would ask for the study showing why that is preferable to taking them at night.

 

[pacergal]

Interesting article.
Per the article: "And people may not want to take certain kinds of blood pressure medications at night, such as diuretics, because they increase urination."

I also have a diuretic. I would not take it at night, I would be up several times. Lack of sleep is definitely not good for my blood pressure.

 

[justlikebike]

My DW's DR just switched her from mornings to nights. Reasoning was that most blood pressure issues happen first thing in the morning as you get up, so better to have the meds in your system already.

 

[kcowan]

My primary HBP is a slow release drug taken in the morning and still working in the wee hours.

 

[RobbieB]

I've always taken my BP meds at night. They do make me a little dizzy, so that's good. They do make me get up and pee 3 times, that's not a problem either, just go back to sleep after.

 

[latexman]

My primary HBP is a slow release drug taken in the morning and still working in the wee hours.

Keith, that's exactly the kind of pill the study covered. One every 24 hours.

The study suggests it's much better to take it at night. They recommend asking your Dr. (after they are aware of this study).

 

[friar1610]

I've always taken my BP med in the morning after getting up. I recently started taking a statin (let's not turn this into a statin thread!) and I've been taking it at night before bed. Just seems to make sense not to take 2 meds at the same time if you don't have to. But now I have a few good questions to ask the doc when I go back for my checkup after 4 months on a statin.

 

[GrayHare]

For me taking meds at bedtime is a recipe for stomach irritation.

 

[Jerry1]

I don’t take blood pressure medicine any longer, but when I did, I took it at night only because it made me a bit sleepy. That just seemed logical at the time.

 

[OldShooter]

I hire an expert to guide me on things like this. My doctor.

The concept of getting health advice from click bait is incomprehensible to me.

 

[RetMD21]

Is the European Heart Journal clickbai?. I have been doing this for over a year. I can't see the harm in taking once a day meds at bedtime.

 

[OldShooter]

Is the European Heart Journal clickbait? ...

At the bottom, all internet "news" articles are clickbait. That's why, for example, many of them are strung out over multiple pages, one or two paragraphs at a time, in order to maximize the number of ads that are inflicted on the reader.

Or did you read the actual journal article completely? I would not say that was clickbait but it is just one study in probably thousands that you have not read.

Re no harm in taking meds at bedtime, maybe true for some drugs and not true for others. That's why I hire a doctor and don't worry about trying to DIY this stuff.

 

[SonofCohoes]

Night for me.

 

[latexman]

Clickbait is not uncommon on the internet, which neither article is. The news story did say,

While the results are encouraging, researchers say patients with high blood pressure should speak with their doctors before making any changes to their blood pressure medication routines.

Sounds like good advice, which is what I did. My Dr. replied to take the beta blocker at night and the diuretic in the morning.

 

[eytonxav]

I've been taking mine at night for many years. Can't remember why I decided that was best, but I've had no problems or side effects.

 

[kcowan]

I wonder if anyone else gets up slowly, particularly for night time voiding.

I sit on the edge of the bed for a minute, then slowly standup for 30 seconds before walking. Several of our friends have awoken on the floor after getting up quickly. They have no history of HBP.

 

[RetMD21]

Oldshooter, you seem like an angry guy. The op was kind enough to link to both the news article and the original paper. This is a huge randomized study with over 19,000 patients. The hazard ratios are all highly statistically significant and the survival curves diverge nicely. I haven't read the "thousands of other articles" but I am glad that you have confidence in your doctor who presumably has. Evidence for the benefit of evening dosing has been around for a while but this is the most solid report. It is reasonable for an individual to ask the doctor about changing if they were explicitly instructed to take a once a day antihypertensives in the morning.

 

[OldShooter]

Oldshooter, you seem like an angry guy. ...

Not angry at all. But trying to make a broader point: For those of us who do not have advanced degrees in the medical field, it is a really bad idea to take action based on reading internet medical stories. There is no quality control and no context. Even more importantly, a large fraction of published papers are eventually found to be based on faked data. So not only do we not have the background to really understand what the paper might mean to us, we also have no way to be sure the whole paper is not bogus.

Does my doctor individually have the ability to read thousands of papers? Of course not, but he is in a large medical group with continuing education programs and he is in a network of his fellow specialists who are continually exchanging information. Might conventional wisdom sometimes suppress a wonderful new finding? of course. But among all the frogs in the world there might also be a disguised prince. Do I think it is wise to make a practice of kissing frogs hoping to someday find that prince? Nope. Not when kissing the frogs might even be hazardous to my health.

Does the @RetMD21 nom de plume imply that you are or were a doctor? If so, what are your thoughts on this general problem?

 

[ExFlyBoy5]

Oldshooter, you seem like an angry guy.

I too am noticing this trend. Isn't this a happy place?

I appreciated the article and after reading it, I looked at the actual study. I think it's very useful information and appreciate the OP sharing it. Much more useful than some user's comments have been.

 

[harley]

Not angry at all. But trying to make a broader point: For those of us who do not have advanced degrees in the medical field, it is a really bad idea to take action based on reading internet medical stories. There is no quality control and no context. Even more importantly, a large fraction of published papers are eventually found to be based on faked data. So not only do we not have the background to really understand what the paper might mean to us, we also have no way to be sure the whole paper is not bogus.

Does my doctor individually have the ability to read thousands of papers? Of course not, but he is in a large medical group with continuing education programs and he is in a network of his fellow specialists who are continually exchanging information. Might conventional wisdom sometimes suppress a wonderful new finding? of course. But among all the frogs in the world there might also be a disguised prince. Do I think it is wise to make a practice of kissing frogs hoping to someday find that prince? Nope. Not when kissing the frogs might even be hazardous to my health.

Does the @RetMD21 nom de plume imply that you are or were a doctor? If so, what are your thoughts on this general problem?

I have gotten some excellent medical information from what you would deride as clickbait articles as well as crowd based forums (like this one). And you're right, there's some trash out there. But there's tons of useful information. Often my doctors have been resistant when the topics are first raised, but it's amazing how often they change their minds *independently* over a period of years. As a snow bird I have multiple doctors. Some are more progressive and willing to listen and study, others are pretty much of the opinion that all medical knowledge was extant during their years in school, and no need to change.

And truthfully, based on overall observation not directly related to this thread, you do seem angry.

 

[marko]

Just started taking HBP meds 3 weeks ago. Dr told me to take them at night as I could get dizzy if taken in the AM.
So far, so good for me.

 

[tulak]

Let’s say the study is bogus and there is no benefit to taking your BP meds in the evening. What’s the difference?

You still have to take the pill.

Looks like a solid study to me, so what’s the harm on taking it in the evening?

Of course, check with your doc if you want.

 

[RetMD21]

There is bad information out there but the article seems solid enough and the linked news article was a pretty fair summary- all one one page so not very click baity. I would take it to be legitimate news. I think a lot of times once daily meds are prescribed w/o reference to when to take them in which case it is probably up to the patient and his/her convenience. The default position is that mostly it doesn't matter when you take meds but chronobiology is fairly new. Although a physician I have no expertise in blood pressure. I appreciated the link.

 

[Richard4444]

This is also common with tamsulosin (Flomax) which, for those partaking, should rise slowly as above.

Rich