In the United States, about one-third of us have high blood pressure. That is roughly 100 million people, and it underlies many chronic illnesses. It is an epidemic, but a treatable one. There are a lot of good medications available; if taken correctly, we lower risk for heart attack, stroke, heart disease and hardening of the arteries.
Blood pressure is continually changing from moment to moment in all of us. From sitting to standing, during exercise and rest, it also fluctuates during the time of day. When we measure blood pressure in the clinic, we take it when the client is sitting down, with their arm at the level of the heart. We do this so we can compare the individual’s blood pressure versus a benchmark. The benchmark for most people sitting with their arm at heart level is 120/80. If yours is close to this number, your blood pressure is considered good, after accounting for individual health conditions.
If you are consistently above the numbers (120/80), you may have hypertension, and your healthcare provider will work with you to adopt lifestyle changes (healthy eating patterns and activities) to help lower blood pressure naturally. If that falls short, your provider will work with you to select a blood pressure medication.
People respond uniquely to different blood pressure medications, and there are many from which to choose. Your provider should be able to describe the different types, and together you should be able to select one that works for you. Lifestyle changes, healthy food choices and your blood pressure medicine will lower your risk for heart disease, stroke, heart attack and other diseases.
A new feature has come to light regarding blood pressure medications: what time during the day to take them. New research finds that taking your blood pressure medication at bedtime may reduce your risk of illness or death.
The timing of medication is important because blood pressure follows a daily rhythm. Usually, it rises higher during the day and falls at night when we sleep. However, there are persons, particularly those of us over the age of 55 years, who have “non-dipping” blood pressure. These persons have a blood pressure that is high late in the day and into the night. Non-dipping blood pressure has shown to be a dangerous phenomenon that causes serious problems (such as heart attacks) in the middle of the night.
Do you have non-dipping blood pressure? Should you take your medication at bedtime rather than in the morning? Research published in the October 2019 issue of the European Heart Journal suggests that maybe you should.
In the study, researchers followed nearly 20,000 patients with high blood pressure for about six years. Half took their blood pressure medication in the morning, and half took it at bedtime. The bedtime patients had lower blood pressure and ended up with fewer cases of heart disease and heart attack.
The evidence is compelling for taking blood pressure medicine at night; however, it is important to work with your provider to determine if changing the timing of your blood pressure medication is right for you. Not everyone in the study responded to the changes, so it is essential not to make nighttime medicating a blanket policy.
If you would like to know more about the research behind the taking of blood pressure medications or have questions about the types of drugs available, please contact Clarke Krugman, Nurse Practitioner at 928-515-0804, or by email: firstname.lastname@example.org. He would be happy to discuss the research and the ways the different medications work to lower blood pressure. QCBN
By David Zelman
David Zelman Practice Manager MA, MAII, PTR Vitality Care Center. For more information, call 928-515-0804, visit the Facebook Page @vitalitycareprescott or email at email@example.com or firstname.lastname@example.org.