The typical advice for when to take yourantihypertensives(high blood pressure medication) has been to take it in the morning. However, there’s growing evidence that most blood pressure medications are more effective when people take them at night.
This is largely due to a concept calledchronotherapy. It is an approach to the timing of medical treatment based oncircadian rhythms, the body’s natural cycle of physical changes that take place every 24 hours. The approach has been used to find the best times of day to treat other medical conditions, includingsleep apnea,chronic kidney disease, anddiabetes.
Advantages of Medicating at Night
Quite a few studies suggest that blood pressure medications may work best when taken at night.
The biggest and most significant of these was the Hygia Chronotherapy Trial. It was a six-year study of more than 19,000 people with high blood pressure.
The researchers divided the participants into two groups. One group took their blood pressure medication in the morning. The other took them at night. At least once a year, all of the participants used ABPM to record their blood pressures.
The researchers found that when compared to the morning group, those who took their blood pressure treatment at night had a lower risk of getting (or dying from) a number of conditions.
For the nighttime medication group:
A 2015 study in the journalDiabetologiafound that taking these medications at night reduced the risk of type 2 diabetes for people with high blood pressure.Other studies report possible advantages of taking blood pressure medication at night. One is that many people are more likely to take their medication before bed rather than in the morning. Another is that the effects of these treatments may wear off more slowly when they are taken at night than when people take them in the morning.
For people who work night shifts, it might be best to take your blood pressure medications before bedtime. Always take any medication according to your healthcare provider’s instructions. If you take your blood pressure medication in the morning, do not start taking it at night without talking to your healthcare provider first.
How Blood Pressure Medication Works
There are 11 categories of blood pressure medication. Each works in different ways, with the overall goal of lowering the pressure in the blood vessels and sometimes also reducing the work that the heart has to do.
When Is Blood Pressure Highest?
Blood pressure rises and falls in a fairly predictable pattern. When you wake up in themorning, it surges. It then increases throughout the day. At night, during sleep, it tends to drop again.
However, this isn’t always the case for people with high blood pressure. In fact, there are four distinct patterns of nighttime blood pressure shifts.
They are:
All three types of abnormal dips in blood pressure are associated with various health risks. They can affect the arteries and heart, kidneys, blood sugar levels, and more.
The only way to know how your blood pressure changes is tomeasure it regularly at different times across the dayand night. One way to do this is with ambulatory blood pressure monitoring (ABPM).
This technique involves wearing a blood pressure cuff like the one your healthcare provider uses in their office. The cuff is linked to a small monitor that can be attached to a belt or an item of clothing. The device automatically takes your blood pressure every 15 or 30 minutes. You use it for a specified period of time, usually 24 or 48 hours.
ABPM measures blood pressure during sleep as well as during waking hours. For this reason, it can be a useful way to find out what kind of dip, if any, someone tends to have at night.
Summary
For some time, people have been told to take blood pressure medications in the morning, when blood pressure tends to surge. The morning hours are also when heart attack, stroke, and other emergencies associated with high blood pressure tend to happen.
There’s growing evidence, though, that it may be best to take these medications at night, before sleep. Studies have found that this timing may reduce the risk of developing some serious health conditions, like heart failure. Be sure to ask your healthcare provider about the best schedule and timing for all your medications.
Frequently Asked QuestionsNo, there is not necessarily a best medicine for high blood pressure. There are multiple categories of medication, such as beta-blockers and vasodilators, that may need to be taken together to effectively lower blood pressure. Since everyone can react differently to medicine, your healthcare provider can help you figure out which will work best for you.In many cases, the effects of blood pressure medicationare gradual. The length of time it takes to work can also depend on the type of medicine. This is why combining a healthy lifestyle (avoiding smoking, eating a balanced diet, staying at a healthy weight) along with your medication can deliver the fastest results for lowering blood pressure.Before you switch taking blood pressure medicine from morning to night, talk to your healthcare provider. They will help decide which time of day is best for you. Recent studies suggest that taking blood pressure medicine at night is more effective, but this change might not offer the same beneficial results for everyone.
Frequently Asked Questions
No, there is not necessarily a best medicine for high blood pressure. There are multiple categories of medication, such as beta-blockers and vasodilators, that may need to be taken together to effectively lower blood pressure. Since everyone can react differently to medicine, your healthcare provider can help you figure out which will work best for you.
In many cases, the effects of blood pressure medicationare gradual. The length of time it takes to work can also depend on the type of medicine. This is why combining a healthy lifestyle (avoiding smoking, eating a balanced diet, staying at a healthy weight) along with your medication can deliver the fastest results for lowering blood pressure.
Before you switch taking blood pressure medicine from morning to night, talk to your healthcare provider. They will help decide which time of day is best for you. Recent studies suggest that taking blood pressure medicine at night is more effective, but this change might not offer the same beneficial results for everyone.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bowles NP, Thosar SS, Herzig MX, Shea SA.Chronotherapy for hypertension.Curr Hypertens Rep. 2018;20(11):97. doi:10.1007/s11906-018-0897-4Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al.Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.Eur Heart J. 2020;41(48):4565-4576. doi:10.1093/eurheartj/ehz754Hermida RC, Ayala DE, Fernández JR, et al.Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation.Chronobiol Int. 2013;30(1-2):280-314. doi:10.3109/07420528.2012.709448Zhang P, Jin MY, Song XY, Wang Z, Jiang YH, Yang CH.Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: a protocol for systemic review and meta-analysis.Medicine (Baltimore). 2021;100(5):e24127. doi:10.1097/MD.0000000000024127American Heart Association.Types of blood pressure medications.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bowles NP, Thosar SS, Herzig MX, Shea SA.Chronotherapy for hypertension.Curr Hypertens Rep. 2018;20(11):97. doi:10.1007/s11906-018-0897-4Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al.Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.Eur Heart J. 2020;41(48):4565-4576. doi:10.1093/eurheartj/ehz754Hermida RC, Ayala DE, Fernández JR, et al.Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation.Chronobiol Int. 2013;30(1-2):280-314. doi:10.3109/07420528.2012.709448Zhang P, Jin MY, Song XY, Wang Z, Jiang YH, Yang CH.Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: a protocol for systemic review and meta-analysis.Medicine (Baltimore). 2021;100(5):e24127. doi:10.1097/MD.0000000000024127American Heart Association.Types of blood pressure medications.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bowles NP, Thosar SS, Herzig MX, Shea SA.Chronotherapy for hypertension.Curr Hypertens Rep. 2018;20(11):97. doi:10.1007/s11906-018-0897-4Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al.Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.Eur Heart J. 2020;41(48):4565-4576. doi:10.1093/eurheartj/ehz754Hermida RC, Ayala DE, Fernández JR, et al.Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation.Chronobiol Int. 2013;30(1-2):280-314. doi:10.3109/07420528.2012.709448Zhang P, Jin MY, Song XY, Wang Z, Jiang YH, Yang CH.Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: a protocol for systemic review and meta-analysis.Medicine (Baltimore). 2021;100(5):e24127. doi:10.1097/MD.0000000000024127American Heart Association.Types of blood pressure medications.
Bowles NP, Thosar SS, Herzig MX, Shea SA.Chronotherapy for hypertension.Curr Hypertens Rep. 2018;20(11):97. doi:10.1007/s11906-018-0897-4
Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al.Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.Eur Heart J. 2020;41(48):4565-4576. doi:10.1093/eurheartj/ehz754
Hermida RC, Ayala DE, Fernández JR, et al.Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation.Chronobiol Int. 2013;30(1-2):280-314. doi:10.3109/07420528.2012.709448
Zhang P, Jin MY, Song XY, Wang Z, Jiang YH, Yang CH.Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: a protocol for systemic review and meta-analysis.Medicine (Baltimore). 2021;100(5):e24127. doi:10.1097/MD.0000000000024127
American Heart Association.Types of blood pressure medications.
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