Oops, I forgot to take my blood pressure medicine today! Should I take it again? How should I take it?

October 8th is National Hypertension Day

Cardiovascular and cerebrovascular diseases are the leading cause of death among Chinese residents. Managing blood pressure is one of the core strategies to curb the prevalence of cardiovascular and cerebrovascular diseases. The three principles of hypertension treatment are "reaching the target, stabilizing, and comprehensive management", among which the rational use of antihypertensive drugs is particularly important. However, in daily management, hypertensive patients often miss taking antihypertensive drugs. What is the correct approach at this time?

If you miss a dose of your antihypertensive medicine, when should you take it again?

Let's take a look at Mr. Wang's experience of taking medicine:

1. Mr. Wang used to go out for a walk in the park every morning after taking a tablet of amlodipine. While walking one day, he suddenly remembered that he had not taken his antihypertensive medicine yet. Should he take the antihypertensive medicine at this time?

2. It was another beautiful day. Uncle Wang boarded the bus to travel early in the morning before taking his antihypertensive medicine. He laughed and talked all the way. When he arrived at the destination, he realized that he had forgotten to bring his antihypertensive medicine. He looked for a pharmacy everywhere. When he got the levamlodipine tablets, it was already 21 o'clock in the evening. So, should he take the antihypertensive medicine today?

There are two basic principles when taking antihypertensive drugs: one is not to stop or miss doses of antihypertensive drugs at will; the other is not to increase or decrease the dosage of antihypertensive drugs at will.

When you miss a dose of your antihypertensive medication, the first thing you need to do is to confirm the time. What time is it now? How long has it been since the original time to take the medication?

If at this moment, less than half of the next scheduled medication time has passed, then you can take a make-up dose in time according to the original dose. So in the first case, Mr. Wang can wait until the end of his walk and go home to take a make-up pill. If half of the time has passed, then don't make up for it, and wait until the next dose to take the original dose. So when Mr. Wang encountered the second case, it had been more than 12 hours since he usually took the medicine. So, don't make up for today's antihypertensive medicine, and wait until tomorrow morning to take it according to the usual dose.

What happens if you miss taking your blood pressure medication?

Antihypertensive drugs can be roughly divided into beta-blockers, diuretics, calcium channel blockers, renin-angiotensin-aldosterone system inhibitors (including ACEI, ARB and renin inhibitors), etc. Each category has its own representative drugs, as well as different doses, dosage forms and fixed combination compound preparations, and combined medications when necessary. The purpose of using antihypertensive drugs is to steadily control blood pressure and reduce the incidence of cardiovascular and cerebrovascular accidents. If antihypertensive drugs are not taken on time, the drug concentration in the body will fluctuate, and blood pressure will also fluctuate accordingly. Although the body will not feel uncomfortable in a short period of time, potential health damage is inevitable. Therefore, no matter which antihypertensive drug is used, it cannot be stopped at will.

In order to stabilize blood pressure and improve medication compliance, researchers are more inclined to develop longer-acting antihypertensive drugs during the development of drug dosage forms. One is to develop drugs with a longer half-life; the other is to make the dosage form into a sustained-release or controlled-release preparation so that the drug is slowly released over 24 hours or longer, thereby effectively and steadily controlling blood pressure.

In the current hypertension treatment guidelines of various countries, it is recommended that long-acting antihypertensive drugs taken once a day be used as a priority for patients with common hypertension.

How to avoid missing antihypertensive medication?

Research data shows that about half of patients with hypertension will miss taking their antihypertensive drugs at least once a month. The harm of missing antihypertensive drugs is not only that it will cause fluctuations in blood pressure, but also that patients will have a fluke mentality, thinking, "Anyway, there is no danger if I take it less a few times. It seems that the antihypertensive drugs are just so effective, and I can take them or not." Therefore, the decrease in medication compliance caused by missing antihypertensive drugs is more dangerous than the missed dose itself.

Although everyone knows that missing a dose of antihypertensive medicine is not good, how can you keep a clear mind and avoid missing a dose? Yaowa has the following suggestions:

1. Deeply understand the importance of maintaining stable blood pressure.

2. Use smart medicine boxes or smart reminder devices such as mobile phone alarms/applets to remind you to take medicine.

3. Place medicine boxes and medicine cabinets in a conspicuous place, but be careful not to let minors get to them.

4. If you take multiple medications at the same time, you can use a portable medication packaging box, especially when you are away from home.

Last but not least, the majority of patients with hypertension are elderly people, and reminders and companionship from family members and caregivers are also very important.