What time of the day should you take your blood pressure medication: morning or evening?

It is a common question for many people. When should the blood pressure medications be taken?

High blood is quite common in the General population. High blood pressure can cause blood vessel damage, heart problems and brain damage.

First of all , Taking medication regularly, at any time of the day, is more important than forgetting to take the medication every day.

If one does take the blood pressure medication regularly, then taking it at evening seems to be more beneficial than taking the medication in the morning.

A Japanese study assessed blood pressure of patients continuously at home. All patients in the study underwent 24-hour ambulatory BP monitoring at baseline. Patients were then followed every year to determine the rate of heart and blood vessel complications .

The Japanese study found that high nightime blood pressure readings were an important sign of future heart problems.

A review by the renowned Cochrane group found that “better blood pressure control was achieved with bedtime dosing than morning administration of blood pressure (antihypertensive) medication”

So if possible taking the blood pressure medication at bedtime makes sense .

References:

(1) Nighttime Blood Pressure Phenotype and Cardiovascular Prognosis. Practitioner-Based Nationwide JAMP Study. Kazuomi Kario, et al. On behalf of the JAMP Study Group.
Originally published2 Nov 2020. https://doi.org/10.1161/CIRCULATIONAHA.120.049730Circulation. 2020;142:1810–1820

(2). Zhao P, Xu P, Wan C, Wang Z. Evening versus morning dosing regimen drug therapy for hypertension. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD004184. DOI: 10.1002/14651858.CD004184.pub2

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Should hormone therapy be used before or after prostate radiotherpy?

Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.

There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.

This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.

One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.

A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.

Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.

My personal view, is that we have to wait for confirmatory evidence before changing the current practice.

I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper

Read the original paper and my published response .

Adjuvant Hormone Therapy After Prostate Radiation: Is This Data Torture?

, MD and , MD. Nottingham University Hospital NHS Trust, Nottingham, United Kingdom

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.