TIME: Evening dosing of BP medication ‘no better or worse’ than morning dosing
Click Here to Manage Email Alerts
Patients taking antihypertensive medication in the evening experienced no difference in MI, stroke or CV death occurrence compared with patients taking them in the morning, a speaker reported.
The results of the TIME study were presented at the European Society of Cardiology Congress.
“Taking prescribed blood pressure tablets in the evening was no better or worse than taking them in the morning for the prevention of cardiovascular disease,” Tom MacDonald, MD, clinical professor of molecular and clinical medicine at the University of Dundee, in Dundee, U.K., said during a presentation. “Taking medication in the evening wasn’t harmful, as far as we could detect, and we conclude patients can take their blood pressure medication in either the morning or the evening, as the timing makes no difference to cardiovascular outcomes.”
MacDonald and colleagues conducted a large, randomized study of 21,104 individuals in the U.K. National Health Service hospital databases treated for high BP. The primary outcome was independently verified MI, stroke and CV death. Patients were followed for a median of 5 years.
The researchers observed no difference in the primary outcome of MI, stroke or vascular death among patients who took their antihypertensive medication at night compared with those taking medication in the morning (HR = 0.95; 95% CI, 0.83-1.1; P = .53).
Moreover, they observed no safety risk for taking BP medication at night compared with in the morning with respect to other outcomes of interest including nonfatal stroke (HR = 0.93; 95% CI, 0.73-1.18; P = .54), nonfatal MI (HR = 0.92; 95% CI, 0.73-1.16; P = .48) and CV death individually (HR = 1.1; 95% CI, 0.84-1.43; P = .49), as well as all-cause death (HR = 1.04; 95% CI, 0.91-1.18; P = .59) and HF hospitalization or death (HR = 0.79; 95% CI, 0.59-1.07; P = .12).
“The key message for this study is that taking your tablets for your high blood pressure in the evening wasn’t different at all from taking them in the morning for preventing heart attacks, strokes or cardiovascular deaths,” MacDonald said during the presentation. “We didn’t find that evening dosing was at all harmful in terms of falls. Patients can take their tablets whenever it’s convenient.”
Perspective
Back to Top
This study is kind of underwhelming. Most of the drug we use are relatively long acting. When in the day you give a diuretic, long-acting ACE inhibitor, etc, is not likely to make a difference.
Obviously, somebody went through a lot of trouble to try to find out whether it made a difference, and it didn’t. This is not a result that I would consider to be unexpected. There really isn’t any difference. You can give BP medicines whenever you want and that’s what I’ve always told patients. When it’s convenient, take it. The most important thing is to take your medicine.
Lisinopril, which is the ACE inhibitor we most commonly use, has an 18-hour half-life. In cases like that, it doesn’t matter when you give the drug.
This is not something that I would have wanted to spend a lot of resources trying to figure out.
Collapse
MacDonald M, et al. Hot Line I. Presented at: European Society of Cardiology Congress; Aug. 26-29, 2022; Barcelona, Spain (hybrid meeting).
Click Here to Manage Email Alerts