Bedtime instead of morning ingestion of hypertension meds = significantly more reduction in cardiovascular disease risk

Clinical Question

Does bedtime ingestion instead of morning ingestion of hypertension medications produce better cardiovascular disease risk reduction in adults with hypertension?

Bottom line

This study found a significant reduction in mortality and morbidity among patients who took their once-daily antihypertensive medications at bedtime instead of on awakening. Although no significant difference occurred in compliance rates between bedtime and awakening ingestion times in this study, individual experiences may differ in clinical practice. 1b-

Study design: Randomized controlled trial (single-blinded)

Funding: Government

Setting: Outpatient (primary care)


David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC

Discuss this POEM



Hypertension study of the decade?

This is the most important study for hypertension I've seen in a long time. Yes, that includes SPRINT. Pt-oriented outcomes, simple intervention, should be practice changing. There is an ongoing pragmatic trial underway in Alberta right now looking at this very question, I'm not sure how many subjects have been recruited.

Joshua Linton Tracey

diuretics @ night?

Great paper... but I'm amazed they managed to dose diuretics at night. They mention no increase in adverse events, but I don't see nocturia specifically measured. Is anyone able to share if this was measured?

Allen Edward G. Ausford

TIME study refutes this

Great to see the new POEM on the TIME study that shows no difference in outcomes with a similar sized study:
Looking forward to seeing the Alberta (actually broader than just one province) study results which should tip the current "tie" in findings