Bedtime Antihypertensive Comparable to Morning Use

A Canadian study of adults with high blood pressure (BP) found no difference in health outcomes between taking BP medications in the morning versus at bedtime. A total of 3,357 adult patients with high BP (56.4% female; median age, 67 years; 53.7% on monotherapy) were randomly assigned to take their once-daily medication either in the morning or at night, and followed for a median of 4.6 years. Researchers found that the timing of medication did not impact the risk of death, hospitalization/emergency department visits for acute coronary syndrome, stroke, or heart failure, and there were no differences in falls, fractures, new glaucoma diagnoses, or cognitive decline between the two groups. A sister study similarly found that nursing home residents (median age 88 years) fared no better or worse if they starting taking their antihypertensives at bedtime. However, a substudy of ambulatory BP monitoring about 10 months into the trial found similar mean daytime BP unchanged with nighttime dosing but overnight mean BP significantly reduced by around -7.4/2.7 mm Hg. The findings suggest that taking BP medication at bedtime is safe but does not offer added benefits over morning use—so patients can choose whichever timing best fits their routine. Source: https://jamanetwork.com/