high blood pressure medication

Best time to take high blood pressure medication


High blood pressure is perhaps the most common chronic health problem of middle age and beyond. Some fortunate people can lower their pressure with weight loss, better diet, and exercise. But many people don’t succeed with that, and should take daily blood pressure medication. But what is the best time to take it? 

Most people 

Most people take their blood pressure medication in the morning. No one knows why this is the pattern. Many doctors, for no particular reason, tell their patients: to take their medication when they wake up. But this study says that the best time to take the medication—is bedtime.  

Spanish research

To determine which is better—take at night or in the morning—a group of Spanish researchers from the University of Vigo recruited 292 doctors in the northern part of Spain. Working together, they assembled 19.084 patients to participate.

This was the best type of research study— a  prospective, randomized double blinded study. At the beginning of the study, 19.084 patients were randomly divided into two groups. One half of the patients were told to take their blood pressure medication when they went to bed. The other half were to take their medication in the morning, when they woke up.


The volunteers were studied over an average of 6.3 years. The researchers studied: which group had more deaths? Which group had more heart attacks and strokes?

They found that there was a clear advantage to take the medication at night, when going to bed.

Much less likely to die

At the end of the study, the people who took their medication at night were 45% less likely to die during the 6.3 years This is a HUGE difference.

Specifically, they found that for the people who took their medication at night, had:

 —A 49% lower risk of a stroke

—A 34% lower risk of heart attack


—during the 6.3 years, the people who took their medication at night were 45% less likely to die, of any cause.

Why night is better

This research, and smaller studies, have shown that the most important time to have blood pressure under control is in the early morning, from midnight to 4 am. more or less.

Night dose

If a person takes their medication at night, the medication starts working during their sleep—including the early mooring hours, the time most important for blood pressure control. For a person with normal blood pressure, their pressure drops at nighttime. It  seems this night time “dip” is best for people with high blood pressure as well.

Most heart attacks in the morning

Another reason taking medication at night is better, is that more heart attacks and strokes occur in the early morning. If a person takes their medication in the early morning, it won’t have time to take effect. But if they take it at night, it will be working during the early morning hours; the most critical time.

Kidney and cholesterol also better

Besides that people who took their medication at night had better night time blood pressure control, they also had better blood pressure control during the day. They also had better kidney function, and a better cholesterol profile as well. 


This is a large, well done study, but carried out  in Caucasian Spanish men and women. It is not known if these results will also be valid for other ethnic groups, or for people who work at night. Also, the researchers need to do further studies to see if their results apply to all types of blood pressure medication.

More research is needed and will be done. But in the meantime, if you take blood pressure medication in the morning, you might bring a copy of this article to your doctor. Maybe your doctor has a specific reason why you should take your medication at a certain time. But if not, is seems that night time dosing is the best.

To find a doctor, of any specialty, anywhere in Brazil, check out our website: www.ProcuraMed.com.

See also in ProcuraMed:

How to self-monitor your blood pressure at home

Esta postagem também está disponível em: Portuguese (Brazil)

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