biological rhythm
in order to adapt to the periodic changes of circadian environment, various functions of the biological world have obvious circadian rhythm. After long-term evolution, a special function & mdash& mdash; The biological clock is used to coordinate the circadian rhythm of various tissues and organs. Various physiological activities in the body change in a certain time order, and the rhythm of this change is called biological rhythm.
as far as individuals are concerned, the physiological function, pathological changes and drug effects of the body are not constant in a day and night. The pharmacological effects of many drugs are closely related to people’s physiological rhythm or pathological rhythm. Under the same dosage, the administration time of the same drug is different, and the body’s reactivity and efficacy to drugs The toxic and side effects will be different, even very different. Therefore, the times of medication must not be the same. Different drugs should have their own best medication time.
Circadian rhythm of blood pressure
human blood pressure shows rhythmic changes in 24 hours: blood pressure rises rapidly to the peak within a few hours after waking up in the morning and falls to the valley from midnight to early morning. That is, the blood pressure level is higher in the daytime and lower in sleep at night.
began to rise at 4:00-5:00 in the morning, peaked at about 6:00-8:00 (also reported as 8:00-9:00), and then gradually stabilized. 16: From 00 to 18:00, the peak (sub peak) appeared again, and then decreased slowly.
reached a low point from 0:00 to 2:00 a.m. (it is also reported that 2:00 to 3:00 a.m.) and remained at 4:00 to 5:00 a.m., with a long handle spoon curve of two peaks and one valley throughout the day.
Spoon type, non spoon type, deep spoon type and reverse spoon type blood pressure
1. Spoon type blood pressure: it refers to that the blood pressure at night decreases by 10-20% compared with that during the day
2 Non spoon blood pressure: refers to the normal part
medication time
specific medication should be adjusted to individual conditions according to different accompanying diseases and different personal conditions.
choose long-acting antihypertensive drugs once a day, which is convenient for patients to take and has good compliance. Long acting drugs and long-acting antihypertensive drugs with high valley peak ratio also have a certain antihypertensive effect when they are missed once a day, so as to avoid the occurrence of dangerous events in the morning.
1. Antihypertensive drugs (including long-term control and sustained-release) taken once a day are mostly administered at 7:00.
2. Take antihypertensive drugs twice a day, preferably at 7:00 a.m. and 14:00-16:00 p.m., so that the peak time of drug action coincides with the two peaks of natural fluctuation of blood pressure.
3. Short acting antihypertensive drugs three times a day. The first time should wake up in the morning, 1 noon, and the last time before 6 pm.
if there is 24-hour blood pressure monitoring (i.e. ambulatory blood pressure monitoring), you can take medicine 1-2 hours before the peak under the guidance of the results of 24-hour blood pressure monitoring.
if 24-hour ambulatory blood pressure monitoring is not performed, patients can select 4 time points in a day, measure blood pressure every 6 hours and continuously measure blood pressure for 3 days to know their blood pressure fluctuation. From this, we can infer a medication time.
It was found that
deep spoon group took medicine in the morning better than at night in changing the circadian rhythm of blood pressure and reducing the morning peak of blood pressure;
non spoon group took medicine at night better than in the morning;
spoon group, taking medicine in the morning and at night can reduce the morning peak;
selecting the medication time according to the circadian rhythm of individual blood pressure can better control the morning peak of blood pressure.
in addition, take medicine when there are no symptoms. Because the damage of hypertension to organs persists, you can’t stop the medicine at will!