Combining Drugs That Lower Blood Pressure And Cholesterol Could Do More To Prevent Stroke
- Combining medication that lowers blood pressure with medication that lowers cholesterol reduced first-time strokes by 44 percent.
- For those with very high blood pressure readings 143.5 mm Hg or higher taking two types of blood pressure-lowering drugs together every day reduced stroke by 42 percent.
Embargoed until 8 a.m. Pacific Time/11 a.m. Eastern Time, Thursday Jan. 25, 2018
This news release is featured in an embargoed media briefing at 3 p.m. PT Wed., Jan. 24, 2018
LOS ANGELES, Jan. 25, 2018 Combining medication that lowers blood pressure with medication that lowers cholesterol reduced first-time strokes by 44 percent, according to research presented at the American Stroke Associations International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians.
Seventy-five percent of strokes are first-time strokes. High blood pressure and high cholesterol both increase the risk for stroke, the fifth leading cause of death in America. Yet, its not known whether combining drugs that lower blood pressure and cholesterol levels can protect individuals from stroke.
Now, a study involving 12,705 participants from 21 countries shows that individually, drugs that lower blood pressure or cholesterol do indeed reduce stroke risk, but when combined, they offer even greater protection.
Among the findings:
Timing May Improve Potency And Help You Cope With Side Effects
We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won’t interfere with each other.
And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.
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When Are Statins Usually Taken
Most statins should be taken every 24 hours however, some people may have to take them twice a day. So, why do people take statins at night? Many statins work more effectively when they are taken at night. This is because the enzyme which makes the cholesterol is more active at night. Also, the half-life, or the amount of time it takes for half the dose to leave your body, of some statins is short.
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How Should This Medicine Be Used
Atorvastatin comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take atorvastatin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take atorvastatin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of atorvastatin and gradually increase your dose, not more than once every 2 to 4 weeks.
Continue to take atorvastatin even if you feel well. Do not stop taking atorvastatin without talking to your doctor.
Best At Night: Aspirin
For years a low daily dose of aspirin was recommended to thin the blood and lower your risk of heart attack and stroke, but recent guidelines now say its unnecessary, except for in those who have had heart attacks or stent procedures. But if youre in the latter group and your doctor recommends continuing, be sure to take your dose at night instead of in the morning. According to Dutch researchers, a nighttime dose drops platelet levels in the morning when they naturally surgeand when cardiac incidents are three times more likely to occur.
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Does It Matter When I Take A Statin
Q. My doctor put me on a statin and told me to take it after dinner. I would rather take it with breakfast. Does it matter?
A. Statins block an enzyme that helps the liver make cholesterol. In most people, cholesterol production peaks late in the evening. The body breaks down fluvastatin , lovastatin , pravastatin , and simvastatin fairly quickly. So taking them in the evening ensures that you have enough medicine on board when you need it the most. Two other statins, atorvastatin and rosuvastatin arent broken down as readily, so you can take them any time.
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How And When To Take Statins
Always take statins exactly as your GP or pharmacist has told you. Check with your GP or pharmacist if you are not sure.
Usually, statins should be taken once a day.
Simvastatin, pravastatin and fluvastatin should be taken at night. This is because most of the cholesterol your body produces is during the night time.
Atorvastatin or rosuvastatin can be taken at any time, as long as you stick to the same time every day.
Statins do not usually upset the stomach. You can take them with or without food.
Swallow statin tablets whole with a glass of water.
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What Foods Should Be Avoided When Taking Statins
Grapefruit and statins: Eating grapefruit, either the fruit itself or as juice, can slow the bodys ability to metabolize statin cholesterol-lowering drugs, which include Lipitor, Crestor and Zocor.
Below are 10 natural ways to improve your cholesterol levels.
- Focus on Monounsaturated Fats.
- Use Polyunsaturated Fats, Especially Omega-3s.
- Avoid Trans Fats.
- Use alcohol in moderation.
How Blood Pressure Medications Work
Blood pressure tends to vary during the day. It tends to be higher when you wake up in the morning and during the morning hours, and lower in the night and when sleeping. However, there are people whose blood pressure does not drop at night researchers call these non-dippers.
Most blood pressure medications have been designed for ease of use, meaning they are meant to be taken once per day. Even so, these medications are not equally effective over the entire 24-hour period during which they are active.
The action of blood pressure drugs peaks anywhere from four to 15 hours later after you take a dose. Ideally, the drug is prescribed so that the peak concentration coincides with the time of day when your blood pressure is at its highest.
There are several different types of blood pressure medications that have different mechanisms of action and are thus best taken at certain times of day.
Medications that are best taken in the morning:
- Diuretics, or water-pills:These include Diuril and Lozol , and work by helping your kidneys get rid of extra water in your body. Because diuretics can cause you to urinate more , its best to take them in the morning. If you need a second dose, take it by mid-afternoon.
Some other common blood pressure medications that are best taken at bedtime include:
- ACE inhibitors , including Lotensin and Vasotec
- ARBs , such as Avapro
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How To Handle Side Effects
Donât stop taking your cholesterol drugs even if they donât make you feel great. Instead, talk to your doctor. There are a few ways they might be able to help you feel better:
Take a brief break. If you have muscle pain, your doctor may tell you to stop taking your drug for a short time and then start it again within a month. The time off can show if your medicine is causing the pain or if itâs due to another problem.
Check your other meds. If you take cholesterol drugs and other medicines, you might be more likely to have side effects. Tell your doctor about everything you take, including prescription drugs, over-the-counter meds, and supplements.
Get a lower dosage. Your doctor may try to reduce how much of your medicine you take. You might also be able to take a pill every other day instead of daily.
Switch treatments. If your side effects are too hard to handle, you might be able to try a different statin such pravastatin and rosuvastatin , which are less likely to cause muscle aches.The cholesterol drug ezetimibe may allow you to take a lower statin dose and thereby help relieve your muscle pain, for example.
Consider OTC treatments. Statins may lower levels of a substance in your muscles called coenzyme Q10, and that can cause pain. You may try taking CoQ10 supplements to get relief. Another option, L-carnitine, might help, too. But always talk to your doctor before you start taking any medicine, even ones you buy without a prescription.
When To Take Your Blood Pressure Medicines
Blood pressure normally decreases overnight, starts to rise before you wake up and then steadily rises during the day.
Diuretics are one type of medicine taken to reduce blood pressure. They increase the need for urination, so they are often taken in the morning to avoid interrupting your sleep. Other anti-hypertensives are also commonly taken in the morning, but a large study in the UK is looking at when is the best time to take blood pressure medicines.
A previous large study has shown that taking blood pressure medications in the evenings leads to better controlled blood pressure and a lower risk of death or illness from heart and blood vessel causes.
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Can I Take Collagen Peptides While On Blood Pressure And Cholesterol Meds: What Kind Of Cold Medicine Can I Take While On Blood Pressure Pills
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When Should I See My Healthcare Provider
While youre taking statins, you should contact your provider if your muscles or joints hurt or if you feel weak, have a fever or your urine is dark.
A note from Cleveland Clinic
Statins can help you reduce your risk of a heart attack or stroke, but they arent a cure for high cholesterol. You should keep exercising and eating healthy even if youre taking statins. And have your cholesterol checked regularly so youll know if the statin is keeping it under control.
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How And When To Take It
Take atorvastatin once a day. You can choose to take it at any time, as long as you stick to the same time every day.
Sometimes doctors may recommend taking it in the evening. This is because your body makes most cholesterol at night. If you’re not sure when to take your medicine, ask a pharmacist or your doctor for advice.
Atorvastatin doesn’t upset the stomach, so you can take it with or without food.
Swallow atorvastatin tablets whole with a glass of water. If you’ve been given chewable tablets, you can chew them or swallow them whole with a glass of water.
Are There Any Other Good Options For Lowering My Bad Cholesterol
Not really. has been a non-statin option. Zetia will lower LDL cholesterol by about 13% and is well tolerated. However, Zetia took a hit after the updated 2013 guidelines for treating high cholesterol were released. Its expensive, and added to a statin it provides no known benefit in prevention of heart disease. There may be more options on the horizon though, in new injectable cholesterol medications Praluent and Repatha.
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Why Are Statins Used
Statins bring down your cholesterol level to make you less likely to have a heart attack or stroke. Your body uses cholesterol when it makes vitamin D, hormones and the acid you use to digest food. But if you have too much cholesterol in your blood, it can collect inside your arteries. This creates obstacles that make it harder for your blood to get through your blood vessels.
If cholesterol keeps building up in your arteries, it can do more than just make them narrow. The plaque in your blood vessels can become unstable and break open, leading to a heart attack.
What Are The Side Effects
You may experience some unwanted effects when taking a statin. These can include:
- muscle aches
Ring 111 if you have any of the following:
- severe chest pain
- acute shortness of breath
- swelling of your mouth, lips or tongue, as this could be an allergic reaction.
Talk to your doctor if your side effects are worrying you. Don’t stop taking your medication without talking to your doctor first. The benefit usually outweighs the side effects.
There’s a very small chance that taking a statin can increase your risk of developing type 2 diabetes. However, the benefits of taking it to reduce your cholesterol usually outweigh the side effects.
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How Blood Pressure Medication Works
There are 11 types of blood pressure medication. Each works in different ways, but the overall goal of hypertension drugs is to make it easier for blood to flow and for the heart to beat.
- Diureticsflush excess fluid and sodium out of the body.
- Beta-blockersmake the heart beat more slowly. They reduce how hard it has to work and the amount of blood it has to put out.
- ACE inhibitorshelp to reduce the amount of a hormone called angiotensin. This hormone causes arteries to narrow.
- Angiotensin II receptor blockers block the receptors for angiotensin to prevent it from narrowing arteries.
- Calcium channel blockersrelax and dilate blood vessels. They also lower heart rate.
- Alpha-blockershelp to relax the walls of blood vessels.
- Alpha-2 receptor agonists lower the activity of the sympathetic nervous system. This is a part of the nervous system that controls heart rate and other involuntary body functions.
- Combined alpha- and beta-blockers are mostly used to treat people having a hypertensive crisis. They are sometimes prescribed for those at high risk of heart failure.
- Central agonists make it harder for blood vessels to contract.
- Peripheral adrenergic inhibitors block chemicals in the brain that play a role in causing blood vessels to become narrow.
- Vasodilators relax the walls of blood vessels. This helps them to widen and allows blood to flow more easily.
Morning Afternoon Or Evening
What is the best time to take statins?
To answer this question, we need to understand a little bit more about these HMG-CoA reductase inhibitors. At the most fundamental level, statins are medicines used to lower blood cholesterol levels.
Indications of statins include:
- Primary prevention of cardiovascular disease
- Secondary prevention of cardiovascular disease
- Primary hyperlipidemia
Statins are used because of their activity at HMG-CoA reductase an enzyme involved in cholesterol production.
More specifically, statins inhibit this enzyme the rate-limiting enzyme in the mevalonate pathway of cholesterol production. Statins are used to reduce levels of harmful LDL cholesterol, whilst increasing the numbers of HDL cholesterol so-called good cholesterol.
Statins also have, through indirect means, the effect of reducing triglyceride levels a harmful kind of lipid that is associated with increasing the risk of cardiovascular disease.
Taken together, statins are a highly effective means to reduce cholesterol levels and prevent the risk of serious cardiovascular events, such as myocardial infarction and stroke.
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Patients Guide: When To Take Your Medication Prescription Or Treatment
If you take a prescription drug or medication, when is the best time to take it?
Most patients try to squeeze in medications around our work schedules or daily routines. For other patients, its simply a matter of taking our medications whenever we can remember to.
Our daily responsibilities can take their toll and interfere with a disciplined medication schedule. Its not always easy. In an effort to help patients with their medications, heres some advice to remember.
Best Two Hours Before Bedtime: Nerve
When youre dealing with chronic nerve pain, you dont want to trade one set of problems for another. And when it comes to medications like gabapentin and pregabalin, you could be doing just that if you take them during the day. Common side effects of medications for nerve pain include drowsiness, confusion, and unsteadiness, which is why its good to take these medications prior to bedtime, says Dr. Ascher. Many patients also complain that their nerve pain will keep them up at night, so I tell my patients to take them two hours before they are ready to go to sleep. Dr. Ascher additionally cautions against taking other prescription pain or antidepressant meds at the same time, as they can increase side effects. He also recommends avoiding antacids two hours before and after your dosage because they can affect absorption and efficacy.
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