Regarding whether to take blood-pressure meds at night,
...the Mayo Clinic says:
In the past, many doctors recommended taking blood pressure medication at night because heart attacks happen most often in the early morning hours. However, since blood pressure typically drops at night in people with normal and high levels, it is unnecessary to drop it further.
...and the National Institutes of Health (NIH) say:
This is a robust study that shows that people who take their blood pressure medication at night have better blood pressure control and have reduced risk of a cardiovascular event such as a stroke or heart attack.
I was woozy and feeling faint for most of Friday morning and afternoon after taking my meds, which I think might need to be dialed down. It's possible I'm doing something wrong in terms of timing, but I think it's also likely that, in terms of BP meds, I'm ingesting too much. It's not blood sugar: my BS readings are still high but slowly coming down. It's definitely BP, which was way low (87/67) early Friday afternoon. So, in exploring the logic of the situation, I started wondering about taking my meds at night. The Mayo Clinic's advice, above, makes it seem as if I might fall into a coma if I'm not careful, whereas the NIH's advice suggests there are benefits to switching to a nocturnal schedule. Obviously, I need to read more, but my own thinking is that I'm less of a mess if I take my meds after eating, and since my roughly 16/8 intermittent-fasting schedule (Newcastle-diet version) skews toward the late end of the day, there'll be food in my stomach* by the time I take my meds at night. We'll see how things are in a few days.
Note: this wouldn't even be a consideration were it not for the fact that the number of pills I now take has more than doubled. Before, when I had only six or eight pills (only!), I had no problem taking them in the morning, in the evening, or whenever. My body mass protected me. Now, though, with so many drugs coursing through my system, I can no longer rely on my body mass to blunt the drugs' effects. I also felt that my body needed a break from the onslaught, so I skipped my insulin and pills today and will restart tonight. No wooziness today at all.
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*I'd felt a bit woozy before Friday, but the moment I ate something, the brain-fog and vertigo lifted, and I felt somewhat better. Food helps.
UPDATE: I'm not asleep yet, but I took my meds tonight, and I'll be curious to see my numbers in the morning. I can already tell that taking meds at night is the way to go. With a more or less full stomach, I'm not suffering any wooziness whatsoever, and the meds, which have to fight through the food, aren't hitting my body with a sledgehammer. Hey, good call, Kevin!
When Dr. Jo prescribes meds, she also specifies the time of day and whether they should be taken before or after eating. The time might depend on the drug. Another thing to ask your doctor about besides the dose of your BP medicine is whether another type would better suit you. I've had my BP drugs changed a few times over the years.
ReplyDeleteGood luck going forward!
Excellent call. Not only will you hopefully suffer less wooziness by taking the BP meds at night, but there's also a good chance that you will cut your risk of all-cause mortality by 50% and cardiovascular mortality by 60% according to a recent study. (See links to two separate studies below).
ReplyDeletehttps://pubmed.ncbi.nlm.nih.gov/33462391/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802365/
Two numbers stuck with me from your post...
First, 87/67 is a scarily low BP reading and I'm guessing the docs will most definitely reduce the dosage of at least some of your meds during your appointment on the 26th.
Second, 16 pills per day? As you know, I'm a big pro-pharmacological intervention kinda guy, but, even to me, that sounds like a helluva lotta prescription meds. What in the world do they have you on and is there any chance they can dial down the dose/number of pills you're taking to avoid the dreaded polypharmacy phenomenon (use of more than 5 prescription drugs at the same time)?
I'm guessing they have you on all the 'majors'
-a BP med (the type of med matters, since beta blockers have very different side effects from ACEs/ARBs)
-a statin (they all work in roughly the same way to lower cholesterol, AFAIK)
-metformin (extended release?)+ injectable insulin
-an anti-platelet
-an anticoagulant
-a stomach protection med to alleviate the burden of all these pills on your gut microbiome
That makes seven, which isn't even half of 16. Now, there is always the possibility that they have you on older meds that need to be taken more than once a day, which would explain the 16 pills.
In any case, make sure that BP doesn't go to low.
And how's the CGM holding up? Planning to buy one soon if you find it helpful in pinpointing foods that spike your post-prandial sugar.