Taking antihypertensive medication in the evening was not harmful and was not better or worse in terms of preventing heart attack, stroke and vascular death than taking the medication in the morning, according to findings from the TIME trial presented Aug. 26 during ESC Congress 2022 in Barcelona.

The trial out of the UK randomized more than 21,000 patients to take their usual blood pressure medication in the morning or the evening. The average patient age was 65 years, 58% were men and 98% were white. The median follow-up was 5.2 years. Patients were followed for an average of five years.

Results found that the primary endpoint – a composite of hospitalization for nonfatal myocardial infarction or nonfatal stroke, or vascular death – occurred in 362 participants (3.4%) in the evening dosing group and 390 patients (3.7%) in the morning dosing group. Researchers noted that the results did not vary in pre-specified subgroup analyses and appear to contradict previous findings that suggested a cardiovascular benefit of night-time dosing.

"TIME was one of the largest cardiovascular studies ever conducted and provides a definitive answer on the question of whether blood pressure lowering medications should be taken in the morning or evening," said Thomas MacDonald, MD, who presented the findings. "The trial clearly found that heart attack, stroke and vascular death occurred to a similar degree regardless of the time of administration. People with high blood pressure should take their regular antihypertensive medications at a time of day that is convenient for them and minimizes any undesirable effects."

Keywords: ESC Congress, ESC22, Antihypertensive Agents, Circadian Rhythm

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