1/8
Hey #medstudenttwitter! I just finished a virtual #familymedicine rotation, and wanted to share something I learned.
When should patients take their blood pressure pills?
#tweetorial #medthread #medtwitter @umnmedschool
Hey #medstudenttwitter! I just finished a virtual #familymedicine rotation, and wanted to share something I learned.
When should patients take their blood pressure pills?
#tweetorial #medthread #medtwitter @umnmedschool
2/8
Patients often ask when they should take their medications. The answer often depends on side effects, such as drowsiness (take these meds at night).
Did you know there's evidence that blood pressure medications actually WORK BETTER if taken before bed?
Patients often ask when they should take their medications. The answer often depends on side effects, such as drowsiness (take these meds at night).
Did you know there's evidence that blood pressure medications actually WORK BETTER if taken before bed?
3/8
The results of a study of over 19,000 patients in Spain was published in October 2019. Patients were randomized to take their antihypertensives before bed or in the morning.
pubmed.ncbi.nlm.nih.gov/31641769/?from…
The results of a study of over 19,000 patients in Spain was published in October 2019. Patients were randomized to take their antihypertensives before bed or in the morning.
pubmed.ncbi.nlm.nih.gov/31641769/?from…
4/8
Bedtime pill-takers ended up with lower blood pressures, and more importantly - fewer heart attacks, strokes, and deaths.
The number needed to treat was about 10 patients.
Bedtime pill-takers ended up with lower blood pressures, and more importantly - fewer heart attacks, strokes, and deaths.
The number needed to treat was about 10 patients.
5/8
Why does this happen?
The renin-angiotensin-aldosterone system is more active at night, so timing antihypertensive therapy (especially ACE-I or ARB) to better align with that system may be part of the reason.
Why does this happen?
The renin-angiotensin-aldosterone system is more active at night, so timing antihypertensive therapy (especially ACE-I or ARB) to better align with that system may be part of the reason.
6/8
Another idea is that better blood pressure control is helpful in the early morning when cortisol peaks and many cardiovascular events seem to happen.
Another idea is that better blood pressure control is helpful in the early morning when cortisol peaks and many cardiovascular events seem to happen.
7/8
It's an simple change with possible benefit - but most patients take their pills in the morning, so changing habits could be hard.
Those in the study didn’t have reduced compliance, but they were likely extra-compliant patients for participating in the study.
It's an simple change with possible benefit - but most patients take their pills in the morning, so changing habits could be hard.
Those in the study didn’t have reduced compliance, but they were likely extra-compliant patients for participating in the study.
8/8
So there you go! Anti-hypertensives taken at night were shown to decrease cardiovascular events and deaths.
A relatively simple result with the potential to change everyday practice.
One of the many reasons I love #familymedicine!
So there you go! Anti-hypertensives taken at night were shown to decrease cardiovascular events and deaths.
A relatively simple result with the potential to change everyday practice.
One of the many reasons I love #familymedicine!
Forgot to add my pretty #infographic!
@GlobalHealthDr @nquadriMD carrying forward the skills you taught us in #COVIDclassroomUMN :)
@GlobalHealthDr @nquadriMD carrying forward the skills you taught us in #COVIDclassroomUMN :)
