Do blood pressure meds make you tired
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Do Blood Pressure Medications Make You Tired?
Introduction to Blood Pressure Medications and Fatigue
Blood pressure medications are commonly prescribed to manage hypertension and other cardiovascular conditions. However, a frequently reported side effect is fatigue. This article explores the relationship between blood pressure medications and tiredness, drawing on recent research findings.
Impact of Blood Pressure Medications on Fatigue
Alpha-Adrenergic Agonists and Fatigue
Alpha-adrenergic agonists, such as midodrine, are used to treat chronic hypotension. Research indicates that these medications can lead to increased blood pressure and changes in autonomic cardiovascular control, which may contribute to symptoms like fatigue and reduced drive2. The counter-regulatory autonomic response to blood pressure elevation, characterized by increased parasympathetic and reduced sympathetic influences, might exacerbate feelings of tiredness2.
Sleep and Blood Pressure Medications
Sleep quality and duration significantly influence the effectiveness and side effects of blood pressure medications. A study on shift workers found that those with short sleep durations who used blood pressure medications had a higher likelihood of experiencing fatigue and other side effects compared to those with adequate sleep3. This suggests that sleep patterns can modulate the impact of these medications on energy levels.
Emotional State, Tiredness, and Blood Pressure
Emotional states and tiredness have been shown to affect blood pressure readings. A study involving users of connected blood pressure monitors found that feeling tired increased systolic blood pressure compared to a neutral state6. This indicates that tiredness itself can influence blood pressure, potentially complicating the management of hypertension and the perceived side effects of medications.
Mechanisms Behind Fatigue Induced by Blood Pressure Medications
Autonomic Nervous System Modulation
Blood pressure medications can alter the autonomic nervous system's regulation of cardiovascular functions. For instance, modafinil, a psychostimulant, was found to increase heart rate and blood pressure, which could lead to autonomic dysregulation and fatigue in patients with cardiovascular conditions1. Similarly, the modulation of autonomic cardiovascular control by alpha-adrenergic treatments can lead to increased parasympathetic activity, contributing to feelings of tiredness2.
Timing of Medication Ingestion
The timing of blood pressure medication ingestion can also affect sleep and fatigue. A systematic review found that taking hypertension medications in the evening rather than in the morning resulted in better clinical outcomes, including improved sleep quality and reduced cardiovascular risk5. This suggests that the timing of medication administration can influence both the effectiveness of the treatment and the side effects experienced by patients.
Conclusion
Blood pressure medications can indeed make you feel tired, primarily due to their effects on the autonomic nervous system and the modulation of cardiovascular control. Factors such as the type of medication, sleep patterns, emotional state, and timing of ingestion play significant roles in the extent of fatigue experienced. Understanding these factors can help in managing the side effects and improving the overall quality of life for patients on blood pressure medications.
Sources and full results
Most relevant research papers on this topic
Modafinil Elicits Sympathomedullary Activation
Modafinil increases heart rate and blood pressure, suggesting caution in its use in patients with cardiovascular disease.
RCTModulations of autonomic cardiovascular control following acute alpha-adrenergic treatment in chronic hypotension
Acute alpha-adrenergic treatment, such as midodrine, may not reduce chronic hypotension symptoms but may exacerbate autonomic dysbalance.
RCTShift Workers Have Higher Blood Pressure Medicine Use, But Only When They Are Short Sleepers: A Longitudinal UK Biobank Study
Shift workers with short sleep duration may be at risk for hypertension, while those with adequate and long sleep durations have protective but nonsignificant effects.
Observational Study
Rigorous JournalSleep and blood pressure.
Sleep leads to a 20% fall in blood pressure in both normotensives and hypertensives, suggesting no centrally-induced vasoactive component and no alteration by hypotensive drugs.
Observational Study
Highly CitedExtent of asleep blood pressure reduction by hypertension medications is ingestion-time dependent: Systematic review and meta-analysis of published human trials.
Bedtime/evening treatment schedules for hypertension medications provide significantly better clinical benefits, including enhanced reduction of asleep blood pressure without inducing sleep-time hypotension and improved kidney function.
Meta-Analysis[LB.01.06] INVESTIGATION OF FACTORS IMPACTING BLOOD PRESSURE ON THE SHORT TERM, BASED ON A COHORT OF USERS OF CONNECTED DEVICES
Short-term emotional state and tiredness can significantly impact blood pressure, with angry, stressed, and sad emotions increasing the difference to baseline.
Observational Study
Very Rigorous JournalShould blood pressure medications be taken at bedtime?
Taking blood pressure medications at bedtime reduces asleep blood pressure and cardiovascular events without compromising daytime BP control.
Antidepressant Drugs Effects on Blood Pressure
Antidepressant drugs can influence blood pressure, with some showing minimal effects and others potentially increasing it or causing orthostatic hypotension.
Literature ReviewSymptoms of low blood pressure: a population study.
Low blood pressure is associated with persistent tiredness, but treatment is not suggested due to potential opposite effects on mortality and morbidity.
Observational StudyHighly CitedFirst-line drugs for hypertension.
First-line low-dose thiazides reduce mortality and cardiovascular events in adult patients with moderate to severe primary hypertension, while reducing adverse drug effects.
Systematic ReviewVery Rigorous JournalHighly Cited