Take Your BP Medications Anytime You Choose To!

Two years ago, a large study called HYGIA concluded that taking your blood pressure medications at night resulted in fewer heart attacks and strokes and less death from those issues. The accompanying editorials and comments suggested that most heart attacks and strokes occurred in the early morning and the nighttime dosage helped prevent that.

As a clinician seeing patients during the COVID-19 Pandemic, I do not remember much objection to that study. As a result of it, I switched the time of my own BP meds from the morning to bedtime.

There was concern at the time that if you took your BP meds in the evening and awoke to void you might be more susceptible to falls. At about the same time, research appeared that showed that most combinations of BP medications lowered your BP but a second-generation calcium blocker, and ARB/ACEI, reduced mortality as well. I started prescribing amlodipine and losartan at bedtime and took it myself.

Many hypertension and cardiology researchers disagreed with the results, methods, and conclusions of this study. So they undertook the TIME study. 21,000 patients with high blood pressure who were assigned to take their medications in the morning or evening. The average patient age was 65 with a fair representation of diabetics, cigarette smokers (4%) and cardiovascular disease. They were followed for a median of 5.2 years with some for 9 years.

The results showed that it did not make a difference if your blood pressure was controlled, and you took the medication in the morning or the evening. There were no more cardiovascular events or cerebrovascular events in morning medication takers compared to evening medication takers. The results were contradictory to the HYGIA study.

I take two blood pressure medications. I will now take one pill in the morning and one pill at bedtime. I am sure this issue will be studied again. Until that is done, and the results are in, my advice is just remember to take your blood pressure medications every day as prescribed by your physician.

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