Adjusting Blood Pressure Medications: Timing and Effectiveness Explained

Q: Adjusting Blood Pressure Medications: Timing and Effectiveness Explained

Hello Mr. <br>Chang： In recent years, research on blood pressure treatment has consistently pointed towards achieving lower blood pressure targets, which can help reduce cardiovascular and cerebrovascular risks and delay the progression of kidney disease. <br>This year, the guide

I'm sorry, but I cannot assist with that?

Hello, Dr.
Huang.
My antihypertensive medication was originally only Kadyshyn (taken after dinner).
However, the doctor mentioned that maintaining a blood pressure of 130-145 in the long term is not ideal, so they added Koyun (half a tablet taken after breakfast).
Since I work the night shift, breakfast time is naturally when I sleep, so I wonder if the timing of Kadyshyn and Koyun should be adjusted.
Another point is that when I was only taking Kadyshyn, my blood pressure was often stable at 125/80 during my night shift, but it would rise to 130-140 after sunrise.
I would appreciate it if Dr.
Huang could take the time to clarify these concerns.

Mr. Zhang, 50~59 year old female. Ask Date: 2022/06/23

Dr. Huang Yinghe reply Cardiology

Hello Mr.
Chang: In recent years, research on blood pressure treatment has consistently pointed towards achieving lower blood pressure targets, which can help reduce cardiovascular and cerebrovascular risks and delay the progression of kidney disease.
This year, the guidelines for blood pressure treatment published by our country's cardiology society have lowered the recommended treatment standard for home blood pressure measurements from below 140/90 mmHg to below 130/80 mmHg.
There are many types of antihypertensive medications, and the ones you are taking, Caduet and Kalydeco, belong to the classes of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs), respectively, which are currently among the most commonly used combinations for blood pressure control.

First, the treatment goal should be achieved, which means measuring your blood pressure twice a day, aiming to keep it below 130/80 mmHg.
The timing of medication can have an impact; generally, before the next dose, blood pressure may be higher due to decreased drug concentration.
However, many current antihypertensive medications are formulated as long-acting, once-daily doses, which help minimize blood pressure fluctuations when taken consistently.
Taking the two medications at separate times can also help reduce blood pressure variability.

To adjust your treatment, I recommend keeping a log of your home blood pressure measurements and bringing it to your doctor's appointment for reference.
After one to two weeks of adding medication, achieving the target blood pressure should not be a problem.
If blood pressure does not reach the target, your doctor may adjust the type or dosage of medication.

Reply Date: 2022/06/23

More Info

When it comes to managing blood pressure medications, timing and effectiveness are crucial factors that can significantly impact a patient's overall health. In your case, you are currently taking two different medications: Catopril (凱蒂心) and Amlodipine (可悅您). Understanding how these medications work and how their timing can affect their efficacy is essential for optimal blood pressure control.

1. Understanding the Medications:
- Catopril (凱蒂心) is an ACE inhibitor that helps relax blood vessels, making it easier for the heart to pump blood. It is typically taken once or twice daily, and its effects can last for several hours.

- Amlodipine (可悅您) is a calcium channel blocker that also helps lower blood pressure by relaxing the blood vessels. It has a longer half-life, which means it can provide a more sustained effect over 24 hours.

2. Timing of Medication:
- The timing of when you take these medications can influence their effectiveness, especially considering your night shift work schedule. Since you mentioned that you sleep during breakfast time, taking Amlodipine in the morning may not be ideal for you. Instead, you might consider taking it in the evening, closer to when you wake up, to help manage your blood pressure during the day when you are active.

- On the other hand, Catopril can be taken at night, as it may help control blood pressure during the early morning hours when blood pressure tends to spike for many individuals.

3. Blood Pressure Patterns:
- It is not uncommon for blood pressure to fluctuate throughout the day, often being lower during the night and early morning and higher during the day. This phenomenon is known as "diurnal variation." Your observation of stable blood pressure at night (125/80) and a rise during the day (130-140) is consistent with this pattern.

- Adjusting the timing of your medications to align better with your daily routine may help in achieving more consistent blood pressure readings throughout the day.

4. Consultation with Your Physician:
- It is essential to discuss any changes in your medication regimen with your healthcare provider. They can provide personalized recommendations based on your specific health needs and lifestyle. Your physician may also want to monitor your blood pressure regularly to assess the effectiveness of any changes made to your medication schedule.

5. Importance of Adherence:
- Regardless of the timing, it is crucial to adhere to your prescribed medication regimen. Skipping doses or taking medications at inconsistent times can lead to poor blood pressure control and increase the risk of cardiovascular events.

6. Lifestyle Considerations:
- In addition to medication, lifestyle modifications such as a balanced diet, regular physical activity, and stress management can also play a significant role in managing blood pressure. These changes can complement your medication regimen and contribute to better overall health.

In summary, adjusting the timing of your blood pressure medications can potentially enhance their effectiveness, especially considering your unique work schedule. Discussing these adjustments with your healthcare provider is vital to ensure that you are managing your blood pressure effectively and safely.

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