Missed blood pressure medication 1 day
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Summary
10 papers analyzed
These studies suggest that missing a single dose of blood pressure medication may have varying effects depending on the specific medication, with some like aliskiren, amlodipine, and telmisartan maintaining better blood pressure control compared to others like enalapril and losartan.
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Impact of Missing a Single Dose of Blood Pressure Medication
Introduction to Blood Pressure Medication Adherence
Adherence to antihypertensive medication is crucial for effective blood pressure (BP) management. However, many patients occasionally miss doses, which can impact BP control. This article synthesizes research findings on the effects of missing a single dose of various antihypertensive medications.
Effects of Missing a Dose of Aliskiren, Irbesartan, and Ramipril
A study comparing aliskiren, irbesartan, and ramipril found that aliskiren provided the most sustained BP-lowering effect after a missed dose. The 24-hour mean ambulatory systolic BP (MASBP) and diastolic BP (MADBP) reductions from baseline were similar for aliskiren and irbesartan but significantly larger than for ramipril. Aliskiren maintained 91% of its BP-lowering effect, compared to 73% for irbesartan and 64% for ramipril, indicating a smaller loss of BP control with aliskiren.
Aliskiren vs. Telmisartan: Sustained BP Control
In another study, aliskiren was compared to telmisartan over a 7-day treatment withdrawal period. Aliskiren showed a smaller increase in 24-hour mean ambulatory systolic BP (2.7 mmHg) compared to telmisartan (6.5 mmHg). This suggests that aliskiren provides more sustained BP control during periods of missed doses.
Amlodipine vs. Losartan: Efficacy in Older Patients
A study focusing on older hypertensive patients compared amlodipine and losartan. Amlodipine was more effective in reducing 24-hour ambulatory BP and maintaining BP control after two missed doses. The increase in BP during the drug holiday was greater for amlodipine, but patients on amlodipine remained at a lower BP level due to its more substantial BP reduction during treatment.
Enalapril vs. Amlodipine: BP Control After a Missed Dose
Research comparing enalapril and amlodipine found that while both medications reduced BP during treatment, enalapril's effect was progressively lost after a missed dose. In contrast, amlodipine maintained BP control up to 48 hours after the last dose, highlighting its sustained efficacy.
Valsartan vs. Enalapril: Sustained BP-Lowering Effects
A study comparing valsartan and enalapril in untreated hypertensive patients showed that valsartan maintained its BP-lowering effect beyond the initial 24 hours after dosing, whereas enalapril did not. This indicates that valsartan is more effective in maintaining BP control after a missed dose.
Candesartan vs. Losartan: Impact of Missed Doses
In a trial comparing candesartan and losartan, candesartan maintained its antihypertensive effects after a missed dose, while BP levels increased towards baseline with losartan. This suggests that candesartan is more reliable in maintaining BP control when doses are missed.
Telmisartan vs. Valsartan: Sustained Efficacy
Telmisartan, with its longer half-life, provided more sustained BP control compared to valsartan, especially at the end of the dosing period and after a missed dose. This makes telmisartan a better option for patients with poor compliance.
Conclusion
Missing a single dose of antihypertensive medication can significantly impact BP control, depending on the medication. Aliskiren, amlodipine, candesartan, and telmisartan have shown more sustained BP-lowering effects compared to their counterparts, making them preferable choices for patients who may occasionally miss doses. Understanding these differences can help clinicians make informed decisions to optimize BP management in patients with adherence challenges.
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