Researchers followed over 21,000 people with high blood pressure for a span of five to nine years. Half of the group took their medication in the morning, the other half in the evening. The study found that hospitalization rates for hypertension were similar between the two timing groups. Observations from this work were presented at the 2022 gathering of the European Society of Cardiology.
“In this study, we explored the possibility of a patient taking a single daily dose of the medication. It is worth noting that this is a relatively uncommon scenario,” one researcher commented.
“The drug effects typically last less than 24 hours, and many patients still need multiple doses per day, though some manufacturers promise longer action,” the researcher added. Hypertension is diagnosed when systolic pressure reaches at least 140 mm Hg on two separate days, or when diastolic pressure exceeds 90 mm Hg on both days. Hypertension is not a death sentence, but it demands careful management because leaving it untreated raises the risk of stroke and heart attack. Modern medications can lower blood pressure effectively and prevent these serious outcomes.
“Doctors have access to several drug groups to lower blood pressure. First are ACE inhibitors and calcium channel blockers. If these are not effective, diuretics can be considered. In any case, therapy should be tailored to the individual, so self-prescribing is not advised,” warned Savonina.
The key to successful treatment is regular adherence and consistency.
“In Russia, people with hypertension and other heart conditions often struggle to stick with the prescribed regimen, sometimes stopping medications due to advice from a taxi driver, a neighbor, or a relative,” she noted. The data are disheartening: only about 40 percent of individuals with hypertension stay on medication, and only around 18 percent reach the targeted blood pressure levels. Part of the challenge is that early-stage hypertension may not cause noticeable symptoms, which diminishes motivation to pursue treatment.
“To improve adherence, using combination pills that contain several active substances can simplify the regimen, since one tablet is easier to take than multiple separate pills,” explained cardiologist Tamaz Gagloshvili.
Savonina added that lifelong blood pressure therapy is common, except in cases where high blood pressure stems from a reversible secondary condition such as kidney disease. Gaglovhvili noted that many instances of secondary hypertension result from sleep disturbances like apnea, which can involve brief respiratory pauses during sleep.
She also mentioned that timing medications can be helpful to reduce side effects in some patients. For example, the calcium blocker amlodipine may raise heart rate in some people; taking it at night can be sensible when nocturnal heart rate slows naturally during sleep.
Gagloshvili added that evening antihypertensive medications are also important for those with nocturnal hypertension, where blood pressure is elevated shortly after waking. The effectiveness of therapy depends on how early treatment begins, making it crucial not to skip the initial evaluation for hypertension.
“Everyone should know their normal blood pressure. This helps detect hypertension promptly. For teenagers, a yearly medical exam is typically sufficient, but it should be performed because high blood pressure can be asymptomatic in young people,” Savonina emphasized.
She cautioned against purchasing generics without medical guidance, as many may be less effective than the original formulations. Medications should be taken with clean water, and caution is advised with grapefruit juice, which can interfere with liver processing of the active substance.
From a dietary standpoint, it is wise to limit salt intake to about one teaspoon per day. Processed and ready-made foods often contain hidden salt, so reading labels matters. However, salt should not be eliminated entirely. Adequate sleep, roughly seven to eight hours, and regular physical activity, such as a daily walk of at least half an hour, also play significant roles in blood pressure management.
Among the risk factors for developing hypertension are obesity, smoking, and physical inactivity, in addition to high salt intake. Lifestyle choices strongly influence treatment outcomes. The same medication can have varying effects depending on body weight, with larger individuals often responding differently than lighter individuals.
Body fat contributes to hormone regulation related to blood pressure and to how well treatment works. Weight loss can reduce or even eliminate the need for medication in some cases. Many people assume pills alone will fix everything, but the outlook largely depends on lifestyle changes in tandem with therapy.