Before the TIME study1, two controversial studies suggested that taking medication in the evening was better in terms of CVD outcomes than taking it in the morning. There were several explanations: BP rises early in the morning, and night dosing would deal with this as it would the nocturnal BP notch, where elevated BP in the middle of the night is associated with poor CVD outcomes.
The TIME study included 24,610 individuals randomised to take their BP medication between 0600 and 1000 hrs or 2000 to midnight. There was no statistical difference in terms of outcomes unadjusted hazard ratio 0·95 [95% CI 0·83–1·10]; p=0·53).
The conclusion was “patients can be advised that they can take their regular antihypertensive medications at a convenient time that minimises any undesirable effects.”