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Blood Pressure dosing (Stroke)

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  • Blood Pressure dosing (Stroke)

    I have a family history of stroke and 20 years BP. I discovered that peak time for a stroke is 6.30 am.(ie when medication levels at lowest.) Dr has requested that I take a week of frequent recordings of BP. This morning I was 196/80 at 7.15 just before medication.
    So, should medication for stroke prevention be twice a day? Dr says at my age, ideal systolic should be < 150.
    johnep

  • #2
    It depends on the half life of the drug how often you need to take it. As for targets we go by NICE: -

    https://www.nice.org.uk/guidance/ng1...ecommendations

    1.4.20 For adults with hypertension aged under 80, reduce clinic blood pressure to below 140/90 mmHg and ensure that it is maintained below that level. [2019, amended 2022]

    1.4.21 For adults with hypertension aged 80 and over, reduce clinic blood pressure to below 150/90 mmHg and ensure that it is maintained below that level. Use clinical judgement for people with frailty or multimorbidity (see also NICE's guideline on multimorbidity). [2019, amended 2022]

    1.4.22 When using ABPM or HBPM to monitor the response to treatment in adults with hypertension, use the average blood pressure level taken during the person's usual waking hours (see recommendations 1.2.6 and 1.2.7). Reduce blood pressure and ensure that it is maintained:
    • below 135/85 mmHg for adults aged under 80
    • below 145/85 mmHg for adults aged 80 and over.

      Use clinical judgement for people with frailty or multimorbidity (see also NICE's guideline on multimorbidity). [2019, amended 2022]
    196/85 is too high, it shouldn’t be that high with medication. I’d advise do a week or so of readings, twice a day when you’re relaxed, and give them to the surgery.
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