People have different practices about the time to take antihypertensive drugs, when should they be taken?
First of all, we need to correct the misconception of a blood pressure lowering standard - 140 and 90 mm Hg, which are well known to almost all the public, and use them as a criterion for judging one's blood pressure status and blood pressure lowering effect.
However, does a drop in blood pressure below these two values mean that the target is met?
01
Definition of hypertension
Let's take a look at the definition of hypertension:
1. Hypertension can be diagnosed if systolic blood pressure reaches or exceeds 140 mm Hg or diastolic blood pressure reaches or exceeds 90 mm Hg without taking antihypertensive drugs.
2. In the three non-consecutive blood pressure measurements, as long as the systolic blood pressure or diastolic blood pressure reaches any of the above standards, it can be recognized as hypertension.
3. Have been diagnosed with hypertension and are currently taking antihypertensive medications, and are still diagnosed with hypertension even if their blood pressure drops below 140/90 mm Hg.
02
Antihypertensive therapy should be pursued gradually
Lowering blood pressure to 140/90 mmHg as a treatment goal is a common misconception.
The goal of lowering blood pressure is not only to lower blood pressure values, but more importantly, to stabilize blood pressure at a healthy level to minimize the occurrence of cardiovascular and cerebrovascular diseases and the risk of death. Therefore, the target value for blood pressure reduction should vary from person to person.
The patient's specific situation should be taken into account when adjusting blood pressure therapy goals. In general, patients with hypertension should aim for blood pressure control below 140/90 mm Hg.
For older hypertensive patients aged 65 years and older, the blood pressure control target can be slightly relaxed to less than 150/90 mm Hg. For patients with other diseases, such as kidney disease and diabetes, the blood pressure control goal is more stringent, which should be less than 130/80 mm Hg.
It is important to note that antihypertensive therapy should not be pursued in a speedy manner, but should be gradual. Lowering blood pressure too quickly can carry a range of risks, including a rapid heartbeat, insufficient blood supply to the brain, myocardial ischemia, and possibly even a heart attack.
03
Patients with high blood pressure should not discontinue the drug at will
In addition, people with high blood pressure should not discontinue the drug at will. The misconception that you can ignore it as long as you take antihypertensive drugs is a common misconception in the management of hypertension. Not all people with high blood pressure can't stop taking the drug. There are three types of people who are likely to stop taking the drug.
1. High blood pressure caused by other diseases is called secondary hypertension. When the underlying disorder has been treated and blood pressure has returned to normal, discontinuation may be considered.
2. Patients with mild to moderate hypertension can temporarily stop taking medication after lifestyle adjustment and short-term drug treatment, and their blood pressure is controlled with the permission of the doctor.
3. When complications occur, such as myocardial infarction and heart failure caused by hypertension, some patients may need to suspend antihypertensive drugs under the guidance of doctors.
Important: Whether patients with high blood pressure can stop taking the drug should follow the doctor's advice and should never stop the drug at their own discretion.
04
Myths about antihypertensive drugs
Taking antihypertensive drugs at night may slow blood flow, leading to cerebral infarction in some people with high blood pressure. So, when should people with high blood pressure take antihypertensive medications?
The first group of people – general patients (people with stable blood pressure and normal blood pressure after taking the medication) is recommended to take antihypertensive drugs in the morning or morning. Taking a long-acting antihypertensive drug at 9 or 10 a.m. is usually effective in controlling the peak of high blood pressure in the morning.
The second group – for those whose blood pressure is difficult to control, may need to take two or three antihypertensive medications. Such patients are not suitable for taking all of their medications at once in the morning.
It is recommended to take one or two medications in the morning and another in the evening. This can not only avoid low blood pressure at night, but also effectively control the peak of high blood pressure in the morning.
The third group of people - high blood pressure during the day and a significant decrease at night, resulting in nocturnal hypotension.
For such patients, it is advisable to take a moderate-acting antihypertensive drug only in the morning to avoid the drug effect lasting 24 hours, resulting in low blood pressure at night.
The fourth group of patients - the morning peak phenomenon is obvious, and the blood pressure is low at night. Such patients are advised to remain awake and not to do activities and to have their blood pressure measured before taking the medication.
After taking the medication, rest for one to two hours before getting up to avoid the risk of blood pressure spikes.
The ideal antihypertensive regimen should be individualized and require constant monitoring and adjustment during treatment. Patients should follow their doctor's instructions strictly when using medications.
Source: Health Talk
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