Benefits to Taking Blood Pressure medication Before Bedtime

[MikeO]

Not sure if anyone here takes there BP meds before bed but, Earlier this year my UWM care team had me change bp meds to just before bedtime.

The reasoning they gave me was that as the drug-s release it kinda follows a curve. Initially the curve goes high then dips so by taking the meds at bedtime i would ride out the high while sleeping. I do have to say it worked for me. Prior to me changing, i would get faint about two hours after taking my pills in the morning after the change my blood pressures were a lot more stable (not perfect but less liable) and had fewer presyncope events

I did make the mistake of lumping in my metoprolol at night but the team put the kibosh on that as my HR went too low and triggered events in my ILR.

I was also reading a study that taking blood pressure meds at bedtime suggests a 45% less chance of experiencing a major cardiovascular event (most happen in the morning hours)

  https://evidence.nihr.ac.uk/alert/taking-blood-pressure-medications-at-night-seems-best/

[yogini]

The purpose of taking “bp meds” aka beta blockers is different for dysautonomia than it is for heart patients.  Dysautonomia patients mostly have a healthy cardiovascular system.  We are not prone to cardiac events like someone with high BP due to being obese, having high cholesterol etc.  Those are not a concern unless you have another condition.  It also depends on the type of dysautonomia you have.  Those with hyper POTS have both high blood pressure and high heart rate.  Me, I tend to have low BP and low HR.  Beta blockers have been around forever are generally considered to be very safe drugs.  I found for me that a low dose beta blocker worked better at night since it made me tired.  If I took it in the day I was too tired, due to the lowering of BP.  My doctor was fine with me taking it at night.I took for years but no longer need the beta blocker,

[MikeO]

5 hours ago, yogini said:

The purpose of taking “bp meds” aka beta blockers is different for dysautonomia than it is for heart patients.  Dysautonomia patients mostly have a healthy cardiovascular system.  We are not prone to cardiac events like someone with high BP due to being obese, having high cholesterol etc.  Those are not a concern unless you have another condition

@yoginiAKA beta blockers are not the first line for hypertension. the usual drugs are lisinopril, losartan and Thiazide-like drug as first line defence. I am happy to hear you are off all meds unfortunately i can't do that. Not sure why you were put on a beta blocker when you have low bp's and heart rate. You are right that folks with vascular diseases need to be managed drug wise but folks otherwise health folks that experience high heart rates and blood pressures are at risk for an event. I only posted what i did as a takeaway to look at your drug strategy.

Personally i would not even be able to get off the recliner with out going tachycardia. beta blockers have helped with that but not my bp"s so hence the secondary drugs. Changing up how and what i take has made a big difference. Downside my bp will just tank and go low i could be 180/115 and drop to 108/64 as Cardiology states it is liable bp. I did post a thread to my tilt table test. https://www.dinet.org/forums/topic/32166-normal-tilt-table-test/ I should have added to this post my med changes included Carvedilol taken twice daily and amlodipine once daily. I take the amlodipine before bedtime rumour this helps out with ankle swelling but. Also amlodipine has a long half life which should help normalize my liable bp's. I do hope this helps and i can tolerate the drug. Carvedilol is a quick acting beta blocker if taken twice daily target here was to make up for the shortcoming of an extended release metoprolol tablet. so it is taken when getting up in the morning and at dinner time.

 

@Pistol I am getting the benefit that my faint team is headed up by the Director of cardiology at UWM Madison and they are tracking me closely. Even my vascular dr heads up research for angioplasty I feel i have a good team. Carvedilol is a good change it is doing it's job thanks! for the support. Amlodipine i have to give it more time but so far so good.

[yogini]

On 10/10/2021 at 1:45 PM, MikeO said:

@yoginiAKA beta blockers are not the first line for hypertension. the usual drugs are lisinopril, losartan and Thiazide-like drug as first line defence. I am happy to hear you are off all meds unfortunately i can't do that. Not sure why you were put on a beta blocker when you have low bp's and heart rate. You are right that folks with vascular diseases need to be managed drug wise but folks otherwise health folks that experience high heart rates and blood pressures are at risk for an event. I only posted what i did as a takeaway to look at your drug strategy.

Personally i would not even be able to get off the recliner with out going tachycardia. beta blockers have helped with that but not my bp"s so hence the secondary drugs. Changing up how and what i take has made a big difference. Downside my bp will just tank and go low i could be 180/115 and drop to 108/64 as Cardiology states it is liable bp. I did post a thread to my tilt table test. https://www.dinet.org/forums/topic/32166-normal-tilt-table-test/ I should have added to this post my med changes included Carvedilol taken twice daily and amlodipine once daily. I take the amlodipine before bedtime rumour this helps out with ankle swelling but. Also amlodipine has a long half life which should help normalize my liable bp's. I do hope this helps and i can tolerate the drug. Carvedilol is a quick acting beta blocker if taken twice daily target here was to make up for the shortcoming of an extended release metoprolol tablet. so it is taken when getting up in the morning and at dinner time.

 

@Pistol I am getting the benefit that my faint team is headed up by the Director of cardiology at UWM Madison and they are tracking me closely. Even my vascular dr heads up research for angioplasty I feel i have a good team. Carvedilol is a good change it is doing it's job thanks! for the support. Amlodipine i have to give it more time but so far so good.

Not sure I understand this response at all.  My post was about the timing of taking beta blockers for dysautonomia. There are hundreds of posts on the forum discussing the timing and safety of taking beta blockers for dysautonomia, not blood pressure.   The risks you posted have not typically been discussed and seemed to be for other conditions not rdysautonomia, buy your doctor could advise you best. 

[MikeO]

On 10/10/2021 at 8:10 AM, yogini said:

The purpose of taking “bp meds” aka beta blockers is different for dysautonomia than it is for heart patients.  Dysautonomia patients mostly have a healthy cardiovascular system.  We are not prone to cardiac events like someone with high BP due to being obese, having high cholesterol etc.

Not sure to answer back but i have seen many folks dealing with dysautonomia taking BP meds and it is not because of a cardiovascular disease. I just went thru ruling out a heart issue being my problem. If you do have a vascular issue the link i posted suggests a better out come. for me timing of meds makes a diff especially the BP medication  my body does not due well with controlling blood pressure. I would rather ride out the highs from the bp meds while i am sleeping than having a pseudoseizure during the day when the meds kick in i have been severely hurt from doing so.. Hyperperfusion of the brain is just as good as a stroke IMO and does initiate pseudoseizures and i can not tell you how much they suck.

Just my 2 cents worth. I still love you Hugs

Mike