Some hypertensive patients have poor blood pressure control because they take medication at the wrong time. It is very important for patients to choose the appropriate time to take medication. So when is the best time for patients with high blood pressure to take medication?
01 Scientific blood pressure control mainly controls two "peaks"
The human body will change its metabolic level according to the biological clock. Therefore, even if the same drug is given at the same dose but at different times, the body's response to the drug, drug efficacy and drug's effect on the body Side effects will also vary.
When to take high blood pressure drugs is mainly determined based on the level of blood pressure fluctuations. Controlled by the biological clock, many life activities of the human body change periodically throughout the day. This characteristic is called circadian rhythm. Under the influence of circadian rhythm, everyone's blood pressure also shows circadian rhythm changes, that is, the changes between day and night are rhythmic. The rhythm of blood pressure in normal healthy people is "two peaks and one trough", that is, blood pressure fluctuates at a high level during the day, gradually decreases from 8 pm onwards, reaches the lowest trough (one trough) at 2-3 am, and then rises again. , blood pressure rises sharply after getting up in the morning (6 a.m.), reaching a peak (first peak) at 8-9 a.m., and then blood pressure continues at a higher level until reaching a peak (second peak) at 4-6 p.m. Then it gradually decreased. Controlling blood pressure mainly involves controlling two "peaks".
02 How to take pay attention to these three points
How should you take antihypertensive drugs? Generally speaking, you should pay attention to the following points.
Take antihypertensive drugs once a day, usually at 7 o'clock in the morning. These drugs act for a relatively long time and can control the "morning peak" of blood pressure.
It is advisable to take antihypertensive drugs twice a day, at 7 a.m. and 4 p.m., so that the time when the drug effect reaches the "peak" coincides with the two peak periods of natural blood pressure fluctuations.
Short-acting antihypertensive drugs should be taken three times a day. The medication should be taken when you wake up in the morning, around 1 p.m., and around 4 p.m.
Of course, everyone’s situation is different. You can also conduct 24-hour blood pressure monitoring before taking medicine to find out your blood pressure peak, and then take medicine 1 to 2 hours before the peak. In this way, blood pressure control is more targeted and individualized. If your situation does not allow for 24-hour blood pressure monitoring, you can also choose 4 time points throughout the day and measure your blood pressure every 6 hours for 3 consecutive days to know your blood pressure fluctuations. From this, a better medication time can be deduced.
03Personalized medication according to the level of blood pressure fluctuations
It is worth noting that most people’s blood pressure drops by about 20% at night when they fall asleep compared to the daytime, so the blood pressure at night is at a low level. If you take antihypertensive drugs before going to bed, it can easily lead to a large increase in blood pressure. Decreases, causing insufficient blood supply to the heart, brain, kidneys and other organs and causing danger. However, some people may experience an increase in blood pressure at night or before taking medicine in the morning. These patients need to follow the pattern of elevated blood pressure and follow the doctor's advice to individually select the type and time of medication. Therefore, patients must monitor their blood pressure frequently, understand the characteristics of their blood pressure changes, and follow the doctor's advice before deciding whether to take medication before going to bed.
In addition, there is a type of antihypertensive drugs called α-blockers (such as terazosin and other "zosin" drugs), which may be used by hypertensive patients with prostatic hyperplasia. This medicine can cause orthostatic hypotension (referring to hypotension caused by insufficient blood supply to the brain due to sudden changes in body position or standing for a long time). Since there are many activities during the day, in order to avoid changes in body position during activities such as standing and walking. If hypotension occurs, it is better to take medication before going to bed.
In short, the taking of high blood pressure drugs is mainly determined based on the level of blood pressure fluctuations.
Author: Zhao Hua, Department of Cardiovascular Medicine, West Branch, Beijing Chaoyang Hospital, Capital Medical University
Editor: Liang Jing
Reviewer: Wu Weihong
This article is from the 2022 issue of "Public Health" magazine. Plan Zero #
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