Which BP medicines should be taken at night?

The use of anti-hypertensive drugs at bedtime or night has been a rare phenomena except when ACE inhibitors are introduced as an add-on therapy for the first week on patients,especially when they are on diuretics like furosemide, which is suspended for some few days.The purpose is to avoid rapid fall in blood pressure which can lead to collapse. It is exciting to know that some drugs have what we called chronotherapeutic benefits related to circadian rhythms. One such drug is doxazosin. Recommending the intake of this drug at night has always offered good blood pressure control. Whenever I carry MUR with my patients and realize that their blood pressure is not under control. I have always advise them to switch doxazosin at night and within three weeks of monitoring the blood pressure, it is amazing to see that the pressure is within sensible range

I recommend to patients on beta blockers, who find that it makes them feel tired and listless, to take their dose at night and most find that it improves this side effect during the day.

Blood pressure tends to vary during the day. Measuring blood pressure in 24 hours  ( ambulatory blood pressure) can give idea on each individual blood pressure and at what times it goes up or down and that will give the best timing for blood pressure treatment. Otherwise 
Timing considerations for high blood pressure treatment are based on type of medicines and on personal routines and lifestyle considerations.
In general, the best time to take your blood pressure medication is the time that fits the best with your lifestyle and makes you the most likely to take the medicine without missing any dose.
Some patient mention that some blood pressure tablets make them tired when they take it therefore it is best to be taken at night.

I approached the practice pharmacist about this topic. Given there have been no changes in guidelines, it will only prove confusing for patients if GPs & pharmacists are not giving them consistant messages