The Best Time of Day to Take Blood Pressure Medications

The best time of day to take your high blood pressure medication varies and is primarily based on the type(s) of medication you’re taking and your blood pressure and treatment goals. For some people with hypertension, it may be beneficial to take one or more of their medications at bedtime, according to recent studies. But any change to your medication routine must be first be discussed with your doctor.

Blood pressure tends to vary during the day; it tends to be higher when you wake up in the morning and during the morning hours, and lower late and night and while you’re sleeping. However, there are people whose blood pressure does not drop at night, who researchers call "nondippers."

Most blood pressure medications have been designed for ease of use, meaning they are meant to be taken once per day. Even so, these medications are not equally effective over the entire 24-hour period during which they are active. The action of blood pressure medicines begins about one hour after ingestion and peaks anywhere from four to 15 hours later. After that, the medicine’s effect slowly decreases until it’s time for the next dose.

For people with normal sleep cycles, this makes sense, as the action of the medicine tends to be the greatest during the period when blood pressure is the highest and slows down at a time when most people are getting ready for sleep. If you work a second or third shift job, though, or have other reasons to consistently be awake at non-standard hours, you may want to adjust your dosing routine to account for these differences.

Some blood pressure medications are usually taken at bedtime because they can cause drowsiness. They tend to be designed to have a slower release of medication so that they still most active in the morning hours when blood pressures tend to be at their peak.

Nondippers, whose blood pressure remains higher through the night, may benefit by taking their once-a-day blood pressure medications at night, according to recent studies. Nondippers are believed to be at higher risk for stroke, heart attack, and kidney disease, and better control at night might reduce those risks. A further study showed this regimen reduced the risk of patients with hypertension developing type 2 diabetes.

Based on these studies, the American Diabetes Association's "Standards of Medical Care in Diabetes—2017" says that doctors should consider administering one or more hypertensive medications at bedtime.

If you would like to adjust the timing of your medications, talk with your doctor. There are some medications that, while they can be taken at any time, cannot be quickly switched from one time to another without some monitoring and adjustment. Interactions with your other medications, food, and drink must also be taken into consideration.

Your blood pressure medication will work best when you take it consistently, so any change of the timing of your dosage should be considered carefully. You would need to set up new habits and reminders so you don't skip any doses. Work with your doctor to decide on an administration plan that meets your schedule and lifestyle needs.