High blood pressure is also known as a silent killer because most people do not realize they have it. A person with high blood pressure does not immediately start showing symptoms. However, if untreated, high blood pressure can make you very sick and even result in death. High blood pressure can result in any of the following conditions:
- Heart attack
- Kidney failure
There is hope, though, in the form of life-saving medicines. People who exercise, eat healthy food and take their medicines every day can keep their blood pressure under control.1 About 1.13 billion people worldwide have high blood pressure, but did you know that maybe only one in five of these manage to keep it under control?2
Could changing the time of your blood pressure medicine help you control it effectively? A new study suggests that taking blood pressure medicines at night rather than in the morning may help reduce the risk associated with high blood pressure by nearly half.3
What does the research say?
A study was conducted across 40 primary care clinics in Spain between 2008 and 2018. Around 19,000 individuals with high blood pressure (average age – 60 years) participated in the study. The participants were divided into two groups. One group was asked to take their blood pressure medicine in the morning and the other group at bedtime. All the individuals were tracked for an average of about six years. Each individual was medically assessed at least once a year and their blood pressure was monitored for 48 hours. The researchers recorded the occurrence of any of the following events in the individuals.
- Heart failure
- Heart attack
- A procedure to widen blocked or narrowed heart arteries
- Death due to cardiovascular diseases
At the end of the study, 9% of the study participants experienced one or more of the above events. The study found that participants who took their tablets at bedtime had 45% lower chances of developing any of the above conditions. The researchers also found that taking high blood pressure medication at bedtime also improved kidney function and significantly lowered the levels of bad cholesterol in the blood.3
In healthy individuals as well as in some patients with high blood pressure, blood pressure exhibits a circadian rhythm, a rhythm that repeats every 24 hours — blood pressure falls at night during rest (dipping), increases steeply in the morning, and peaks generally in the afternoon.4 However, in some individuals with high blood pressure, blood pressure does not fall at night (non-dipping).5 This could be because the effect of their high blood pressure medicines does not last for a sufficient time. The effect of the medicines taken in the morning possibly wears off by night, resulting in non-dipping.6 Many studies suggest that such individuals have prolonged exposure to high blood pressure over 24 hours and may have increased complications from high blood pressure.
As seen in several studies, taking your blood pressure medicines at bedtime may prevent complications from prolonged exposure to high blood pressure.5 However, you should consult your physician before making any alterations to your current blood pressure medication routine.7
Also, just taking medicines is not enough. When the medication regimen is accompanied by healthy eating and an active lifestyle, your body would be healthy for a longer time. So, take charge of your health and treat your body like the temple it is, only then will it serve you well.
- U.S. Food and Drug Administration. High blood pressure–medicines to help you [Internet]. [updated 2019 May 22; cited 2019 Nov 18]. Available from: https://www.fda.gov/consumers/free-publications-women/high-blood-pressure-medicines-help-you.
- World Health Organization. World hypertension day 2019 [Internet]. [cited 2019 Nov 18]. Available from: https://www.who.int/cardiovascular_diseases/world-hypertension-day-2019/en/.
- Hermida RC, Crespo JJ, Domínguez-Sardiña M, Otero A, Moyá A, Ríos MT, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J. 2019 Oct 22;pii:ehz754. doi: 10.1093/eurheartj/ehz754.
- Douma LG, Gumz ML. Circadian clock-mediated regulation of blood pressure. Free Radic Biol Med. 2018 May 1;119:108-114. doi: 10.1016/j.freeradbiomed.
- Cuspidi C, Michev I, Meani S, Valerio C, Bertazzoli G, et al. Non-dipper treated hypertensive patients do not have increased cardiac structural alterations. Cardiovasc Ultrasound. 2003 Feb 14;1:1.
- Chonan K, Hashimoto J, Ohkubo T, Tsuji I, Nagai K, Kikuya M, et al. Insufficient duration of action of antihypertensive drugs mediates high blood pressure in the morning in hypertensive population: the Ohasama study. Clin Exp Hypertens. 2002 May;24(4):261-275.
- American Heart Association. Managing high blood pressure medications [Internet]. [updated 2016 Oct 31; cited 2019 Nov 18]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-high-blood-pressure-medications.