When should you take your blood pressure medication?

Podcast Transcript

Announcer:
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Dr. Laffin:
My name's Luke Laffin and I'm a preventive 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.

Dr. Laffin:
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.

Dr. Laffin:
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 diarrhetics right before we go to bed, we do risk that happening.

Dr. Laffin:
What I'll oftentimes recommend to individuals is if you're taking medications and such as beta blockers or calcium channel blockers or blockers of the renin-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.

Dr. Laffin:
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 two to three 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.

Dr. Laffin:
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."

Dr. Laffin:
Patient adherence and medication adherence is very important and that leads to better cardio vessels.

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