Should blood pressure medications be taken in the morning or evening?

ESC 2022 A large randomized study found that taking BP medications in the evening was no better or worse than taking them in the morning for the prevention of CVD.

Presented at the ESC congress 2022 by: Prof. Thomas MacDonald, MD – Dundee, UK

Introduction and methods

TIME was a large prospective, randomized trial that investigated whether taking BP medications in the evening improves CV outcomes compared to taking the medications in the morning. A total of 21,104 participants (average age was 65 years, 58% were men and 98% were white) from the UK were randomized in a 1:1 ratio to take their usual BP medications in the morning or in the evening. The composite primary endpoint was hospitalization for nonfatal myocardial infarction or nonfatal stroke, or vascular death, in the intention-to-treat population. Secondary outcomes were non-fatal stroke, non-fatal MI, CV death, all-cause mortality and CHF hospitalization. Median follow-up was 5.2 years.

Main results

• There was no difference in the primary outcome between the morning dosing and the evening dosing group (HR 0.95, 95% CI 0.83-1.10, P=0.53).
• There were also no differences between groups for the secondary outcomes.
• Pre-specified subgroup analyses showed also no differences between groups.

Conclusion

This large randomized study found that taking BP medication in the evening was no better or worse than taking them in the morning for the prevention of MI, stroke or vascular death. The key message of this study, according to Prof. MacDonald, is that patients can take their BP medications whenever it is convenient.

-Our reporting is based on the information provided at the ESC Congress-