Biological rhythms In order to adapt to the cyclical changes of the circadian environment, various functions in the biological world have distinct circadian rhythms. Through long-term evolution, a special function, biological clock, has been developed in human body to coordinate the circadian rhythms of various tissues and organs. Different physiological activities in the body change in a certain time sequence, and the rhythm of this change is called biological rhythm. As far as the individual is concerned, the physiological functions and pathological changes of the organism as well as the effects of drugs are not constant during the day and night. The pharmacological effects of many drugs are extremely closely related to people’s physiological or pathological rhythms, and the reactivity, efficacy and toxic side effects of the organism to drugs can be different or even very different under the same dose and different administration time. Therefore, the number of medications should never be the same, and different drugs should have their own optimal dosing time. The circadian rhythm of blood pressure The human blood pressure shows a rhythmical change in 24 hours: it rises rapidly to a peak within a few hours after waking up in the early morning and falls to a trough between midnight and early morning. That is, blood pressure levels are higher during the day and lower at night while sleeping. It starts to rise in the early morning at 4:00-5:00 am, peaks around 6:00-8:00 am (also reported as 8:00-9:00 am), and then gradually plateaus. 16:00-18:00 am peaks again (sub-peak), and then slowly declines. A trough is reached at 0:00-2:00 am (also reported at 2:00-3:00 am) and maintained until 4:00-5:00 am, with a double peak and a long-handled spoon curve throughout the day. Spoon, non-spoon and deep spoon, anti-spoon blood pressure 1, spoon blood pressure: refers to the night compared to the daytime blood pressure drop of 10-20% 2, non-spoon blood pressure: refers to the normal part of the population whose night blood pressure does not drop significantly, or the night blood pressure drop of less than 10% 3, deep spoon blood pressure: refers to the part of the population with excessive night blood pressure drop, more than 20% 4, anti-spoon blood pressure: hypertensive patients with night blood pressure The ideal antihypertensive drug should be able to lower blood pressure smoothly within 24 hours, significantly reduce the patient’s early morning blood pressure, so that hypertensive patients safely through the high incidence of cardiovascular and cerebrovascular events; can restore the patient’s “normal” blood pressure pattern, reduce blood pressure variability, and effectively protect target organ function. This is the “Chronotherapy” of hypertension. The timing of the medication should be tailored to the individual depending on the concomitant disease and individual circumstances. Long-acting drugs with high valley-to-peak ratios have a certain effect on lowering blood pressure even if they are missed once in a while, so as to avoid the occurrence of dangerous events in the early morning. 1, 1 day to take 1 time of antihypertensive drugs (including long-acting control, slow-release system) more at 7:00 pm dosing. 2, 1 day to take two times the antihypertensive drugs, to 7:00 a.m. and 14:00-16:00 p.m. two dosing is appropriate, so that the drug action peak time coincides with the natural fluctuations in blood pressure of the two peak periods. 3, short-acting anti-hypertensive drugs three times a day, the first should be woken up in the early morning, 1:00 noon, and the last before 6:00 pm. If 24-hour blood pressure monitoring (i.e. ambulatory blood pressure monitoring) is available, the medication can be taken 1-2 hours before the peak as guided by the results of the 24-hour blood pressure monitoring. If 24-hour ambulatory blood pressure monitoring is not available, patients can choose 4 time points in the day and take their blood pressure every 6 hours for 3 days to be able to know their blood pressure fluctuations. From this, a time to take the medication can be inferred. It was found that in terms of changing the circadian rhythm of blood pressure and lowering the morning peak, the early morning dose was better than the evening dose in the deep spoon group; the evening dose was better than the early morning dose in the non-spoon group; both the early morning dose and the evening dose reduced the morning peak in the spoon group; and choosing the time of dosing according to the circadian rhythm of individual blood pressure could better control the morning peak. In addition, medication should be taken even when asymptomatic. Because the damage of hypertension to organs is continuous, you should not stop the medication at will!