When should you take your blood pressure pill? In the morning or at night?

A recent Chinese study overturns what was once thought to be the best practice: taking the pill in the morning. In fact, it's better to take it in the evening.

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when to take blood pressure pills

When should you take a blood pressure pill to avoid wasting its effects? Is it better in the morning or in the evening? These are frequently asked questions, given that according to data from the Istituto Superiore di Sanità (ISS), in Italy, among people aged between 35 and 74 years about 49 percent of men and 39 percent of women they are considered hypertensive, including those undergoing drug treatment. 

Until now it was thought, also on the basis of scientific evidence, that it made no difference whether you took this precious medicine, which can save your life, in the morning or in the evening: the risks of ictus or heart attacks did not vary based on the timing of pill taking.

 But a Chinese research published in August 2025 on the pages of the journal JAMA Network Open the picture changes, and not in an insignificant way. 

Chinese researchers examined 720 hypertensive patients, dividing them into two groups: half took the pill in the evening and the other half in the morning. The results were surprising: The reduction in the risk of stroke and cardiovascular disease was significantly greater when the pill was taken in the evening. 

And the reason is linked to a specific fact: protection from blood pressure spikes is essential early in the morning, between 4 a.m. and the time you wake up. If you take your blood pressure pill in the morning, for example between 8 and 9 a.m., its effect will have worn off by 4 a.m. 

But why is blood pressure medication so important for people with hypertension?

THEhypertension It is one of the main risk factors for cardiovascular disease, stroke, and kidney failure. When high blood pressure remains high over time, it damages blood vessel walls, promoting plaque buildup and increasing the risk of clots. For this reason, controlling blood pressure with specific medications is not a matter of comfort, but rather of preventing potentially fatal events.

The active ingredient in antihypertensive drugs works to reduce blood pressure, easing the heart's workload and protecting vital organs. However, as Chinese research highlights, the timing of administration plays a crucial role in the treatment's effectiveness. So-called "night dipping"—the natural decrease in blood pressure during sleep—is a protective factor typical of healthy individuals. In hypertensive patients, this reduction doesn't always occur, resulting in blood pressure spikes precisely in the early morning hours, the time of day when our bodies prepare to wake up.

Taking the drug in the evening provides adequate protection during the night and in the early hours of the morning, when cardiovascular risk is statistically highest. This is the critical time when heart attacks and strokes are most common in the general population. A study previously published in the journal Hypertension had already suggested this association, but the Chinese results now provide even stronger evidence of the superiority of evening administration.

Naturally, any changes to your treatment regimen should be discussed with your primary care physician or cardiologist, as the timing of administration depends on the patient's individual characteristics, comorbidities, and any other medications they may be taking. However, for most hypertensive patients, the simple act of taking the pill at sunset rather than sunrise could be an effective strategy to further reduce the risk of serious complications and live longer and healthier lives.

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