At present, most of the antihypertensive drugs are long-acting preparations once a day, and the antihypertensive drugs once a day should be taken in the morning or at night?
In fact, most of the long-acting antihypertensive drugs are recommended to be taken in the morning, this is because the body's blood pressure has its own circadian rhythm, there are two blood pressure peaks during the day, and there is a blood pressure trough at night.
Arytenoid blood pressure has a blood pressure peak in the morning and afternoon, therefore, once a day antihypertensive drugs, scheduled to be taken in the morning, can cover two blood pressure peaks throughout the day, and if you take the medicine at night, because there will be a blood pressure trough in the middle of the night, taking antihypertensive drugs at night will lower the blood pressure at night, which is very dangerous, especially for the elderly, due to vascular endothelial dysfunction, Decreased sensitivity to baroreceptor reflexes leads to a decrease in blood pressure self-regulation and a decrease in tolerance to hypotension, which can lead to a decrease in blood perfusion to important organs and induce serious cardiovascular events such as myocardial infarction and cerebral infarction.
However, there are also a considerable number of hypertensive patients, whose blood pressure does not show a standard dipping type of two peaks and one valley, but is manifested as a high blood pressure at night, which becomes a reverse dipping type in medicine.
In fact, for people with nocturnal hypertension, it does not matter whether to take antihypertensive drugs in the morning or at night, the key is to choose those really long-acting antihypertensive drugs, such as amlodipine, perindopril, telmisartan, or nifedipine controlled-release tablets, metoprolol succinate sustained-release tablets, etc., are all long-acting antihypertensive drugs recommended by relevant guidelines, and some antihypertensive drugs with a half-life of less than 8 hours, such as valsartan, losartan, and metoprolol ordinary tablets, can not achieve a 24-hour antihypertensive effect when taken once a day, and need to be taken twice.
In conclusion, current research suggests that to control nocturnal hypertension, it is more important to choose long-acting antihypertensive varieties to be taken in sufficient amounts, or a combination of two or more drugs, rather than struggling with whether to take it in the morning or at night.
Reference: Chinese Expert Consensus on the Management of Nocturnal Hypertension 2023