From the Guidelines
The best time to take anti-hypertension medications is at the most convenient time of day to improve adherence, as current evidence does not show a benefit of diurnal timing of BP-lowering drug administration on major CVD outcomes. According to the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1, patients should be encouraged to take medications at the same time each day and in a consistent setting to help ensure adherence. Some key points to consider when deciding on the timing of anti-hypertension medication include:
- Taking medication at the same time each day to maintain steady blood levels and effectiveness
- Choosing a time that is most convenient and easiest to remember, to improve adherence
- Considering the type of medication and its potential effects on daily activities, such as diuretics which may be better taken in the morning to avoid nighttime urination
- Following the specific instructions of your doctor, as they may have recommendations based on your individual health profile. It is also important to note that the timing of medication should be individualized to each patient's lifestyle and preferences, as this can help improve adherence and ultimately lead to better blood pressure control 1.
From the FDA Drug Label
In most patients studied, onset of antihypertensive activity was seen at one hour after oral administration of an individual dose of lisinopril, with peak reduction of blood pressure achieved by 6 hours The best time to take anti-hypertension meds, specifically lisinopril, is in the morning, as the peak reduction of blood pressure is achieved by 6 hours after oral administration. However, the exact timing may vary depending on individual patient factors, and it is essential to follow the prescribed dosage and administration instructions provided by a healthcare professional 2.
From the Research
Optimal Timing of Antihypertensive Medication
The optimal time to take anti-hypertension medication is a topic of ongoing research. Several studies have investigated the effects of taking antihypertensive medication at different times of the day.
- A study published in 2012 3 found that taking antihypertensive medication in the evening or at bedtime was more effective in treating morning hypertension than taking it in the morning.
- Another study published in 2020 4 reviewed the current evidence on the timing of antihypertensive medication dosing and found that taking medication before sleep rather than upon waking had benefits, including enhanced reduction of asleep blood pressure and increased sleep-time relative blood pressure decline.
- A 2019 study 5 investigated the efficacy of different combinations of antihypertensive therapy on blood pressure and arterial stiffness, but did not specifically examine the timing of medication dosing.
- An older study from 1993 6 found that the combination of amlodipine and lisinopril had a marked additional effect on blood pressure compared with either drug alone, but did not investigate the timing of medication dosing.
- A recent systematic review and meta-analysis published in 2023 7 compared the efficacy of dosing antihypertensive drugs in the morning versus evening and found that evening dosing significantly reduced ambulatory blood pressure parameters and lowered cardiovascular events, although the effect was mainly driven by trials from one research group.
Key Findings
- Taking antihypertensive medication in the evening or at bedtime may be more effective in treating morning hypertension than taking it in the morning 3, 4.
- Evening dosing of antihypertensive drugs may reduce ambulatory blood pressure parameters and lower cardiovascular events 7.
- The timing of medication dosing may not be as important as other factors, such as adherence to the medication regimen and minimizing undesirable effects 7.