Hypertension is a disease that is familiar to people nowadays. According to statistics, there are currently more than 270 million hypertensive patients in my country, and they are becoming younger.
Generally speaking, most diagnosed hypertensive patients need to be treated with antihypertensive drugs to achieve their blood pressure. But sometimes this happens:
Obviously, I have been taking antihypertensive drugs. Some people control their blood pressure well, while others can't control their blood pressure.
Take an example: Isolate Pharaoh Wang and Cunkou Lao Li have similar high blood pressure conditions. The doctor prescribed the same antihypertensive drugs for them, and they insisted on taking it every day, but Pharaoh’s blood pressure was like a roller coaster ride. , Is often unstable, and Lao Li's blood pressure is stable.
What is the reason?
In fact, this may be related to the time of taking antihypertensive drugs.
Patients with hypertension have the best time to take antihypertensive drugs. Because even with the same dose of the same drug, the time of taking the drug is different, the body's responsiveness to the drug, efficacy and drug side effects will also have certain differences.
Therefore, only a reasonable choice of the time of administration can make the antihypertensive drug play the most effective .
Then when should I take antihypertensive drugs to maximize their effects?
In general,The best time to take the medicine mainly depends on the following three points: First look at the blood pressure fluctuations, second look at the effectiveness of antihypertensive drugs, and third look at the type of antihypertensive drugs.
First: Look at blood pressure fluctuations, take the medicine time
Medical research shows that human blood pressure fluctuations are regular. Under normal circumstances, blood pressure is periodic in 24 hours day and night Rhythmic changes.
Generally speaking, blood pressure will fluctuate like "two peaks and one valley" in 24 hours:
blood pressure reaches its peak at 9-11 in the morning, and then begins to drop, until 16-18 in the afternoon It rose to another peak again, and gradually fell after 18:00. After falling asleep, the blood pressure continued to drop, and the blood pressure reached its lowest point at 2-3 in the morning.
This kind of blood pressure fluctuation curve resembles a spoon shape. We vividly call this kind of blood pressure "spoon type hypertension" . According to this rule, the best time to take antihypertensive drugs for patients with spoon-type hypertension is:
Antihypertensive drugs taken once a day, including controlled-release tablets and sustained-release tablets, preferably at at 7 am :00 take the medicine;
take the antihypertensive medicine twice a day, it is recommended to take the medicine at 7:00 am and 14:00 pm ;
take the antihypertensive medicine 3 times a day, the first time should be early morning Take immediately after waking up,The last time you should take before 19:00 in the evening .
In this way, the time the drug takes effect (most long-acting antihypertensive drugs now take about 2 hours after taking the drug) , which coincides with the two peak periods of blood pressure fluctuations, and can be better The peak blood pressure is lowered, and blood pressure is safer.
Of course, not all patients have "spoon-type hypertension", and there are many hypertensive patients whose blood pressure fluctuations are not "spoon-type", but "back-spoon-type high" which is high at night and low in the morning. Blood pressure" .
In this case, you can choose to take medication before going to bed, or perform 24-hour blood pressure monitoring under the guidance of a doctor to find out your blood pressure peak, 2 hours before the highest blood pressure value appears Medication.
Second: Look at the effectiveness of antihypertensive drugs and take the time
The dosage forms of antihypertensive drugs are mainly divided into three major types: short-acting, medium-acting and long-acting Different time-effective antihypertensive drugs are suitable for different times.
Commonly used are nifedipine, captopril, verapamil, etc. The maintenance time of these drugs is not long (usually maintained for 5 to 8 hours About), but the effect time is very fast (about 15-30 minutes). and so,When encountering a sudden increase in blood pressure, these drugs are often used as first aid medicine.
These drugs are recommended to be taken three times a day to ensure stable blood pressure throughout the day. It's best to be at 6 o'clock in the morning, about 12 o'clock noon and 19:00 in the evening.
Commonly used are enalapril, felodipine, metoprolol and so on. The onset time of this kind of drugs is about 6 hours, and the time to maintain in the blood is about 10 to 12 hours.
Intermediate antihypertensive drugs are taken twice a day, and it is generally recommended to take them once in the morning and evening.
Commonly used are amlodipine, benazepril and sartan antihypertensive drugs. Long-acting antihypertensive drugs can usually maintain the antihypertensive effect for more than 24 hours.
Therefore, it only needs to be used once a day. In order to effectively control the blood pressure for 24 hours, you can usually take it at 6-7 in the morning.
Third: Look at the type of antihypertensive drugs, the time of taking the medication
At present, the clinical first-line antihypertensive drugs mainly include 6 categories: diuretics , beta blockers Agents, ACEI or ARB, calcium antagonists and alpha blockers.
Some medicines are best taken half an hour before a meal and on an empty stomach.For example, captopril , this is because food can reduce its absorption rate by 30%-40%.
There are also alpha blockers , such as terazosin and doxazosin . This type of medicine may cause orthostatic hypotension, so it is better to take it before going to bed .
and diuretic antihypertensive drugs or diuretic antihypertensive drugs should be taken after breakfast, not before going to bed, because they may affect sleep due to diuretic effects (more at night) .
Of course, the above is only the general time of taking medication, and it does not apply to all patients. Because everyone is an independent individual, each person's blood pressure also has its own characteristics of changes.
The best advice is to go to the hospital for help. Under the guidance of doctors, patients use 24-hour ambulatory blood pressure monitoring to find out their blood pressure changes and formulate a reasonable time for medication.
However, it should be noted that even if we have a reasonable time to take the medicine, if there are the following high blood pressure misunderstandings, blood pressure may still be poorly controlled.
Stop the drug when the blood pressure is normal
High blood pressure is different from a cold. There is currently no cure for high blood pressure.Most can only be controlled by long-term medication, or even lifelong medication. If the medication is stopped arbitrarily during this period, blood pressure will not only rise again, but may also bring other serious consequences.
The lower the blood pressure, the better
Many hypertensive patients will enter this error zone, but when the blood pressure of the body is lower than a certain level, the blood flow will be reduced. , Easy to induce cardiovascular and cerebrovascular events. Therefore, the lower the blood pressure target value is not the better, and the specific blood pressure standard depends on the doctor.
do not take medicine if there is no symptoms
When blood pressure rises, some hypertensive patients will feel headache, dizziness, and tinnitus. There are no such symptoms, but no symptoms does not mean that there is no harm. By the time myocardial infarction, cerebral infarction, or cerebral hemorrhage occurs, it may be too late. Therefore, patients with hypertension should take medication when their blood pressure rises, regardless of whether they have symptoms or not.
Finally, I would like to remind everyone again that for hypertensive patients to achieve a good blood pressure control effect, it is not only necessary to adhere to the medication, but also to take the medication correctly.
As for how to take high blood pressure medicines correctly, it’s up to the doctor, that’s right!
.[1] Zhang Xinjun. Is it better to take antihypertensive drugs once a day or in the morning and evening? [J]. Chinese Journal of Hypertension, 2020,28(06):505-509.
[2] Ho Yu. How to take antihypertensive drugs the most reasonable? [N]. Health Care Times, 2017-06-01(012).
[3] Duan Na. The pressure difference between day and night is large,Take medicine to see the time period[J].Jiangsu Health Care,2020(05):13.
[4]Lu Jizong.Why should "Morning Peak Hypertension" take medicine before going to bed[J].Knowledge of Cardiovascular Disease Prevention and Treatment (Science Edition), 2017(01):15-17.
[5]. Guidelines for the rational use of hypertension (2nd edition)[J]. Frontier Journal of Chinese Medicine (Electronic Edition), 2017,9(07):28-126.
[6] Don't ask before or after meals, there is an optimal timetable for taking "heart protection" medicine, Life Times, 2018-03-14
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