Dosing Time for Daily Antihypertensive Medications Didn't Affect Cardiovascular Outcomes

Blood pressure (BP) typically dips overnight and surges in the morning. Adverse cardiovascular (CV) events occur more frequently with the usual morning surge and in people who do not have usual diurnal BP variation. Two studies have reported a marked reduction in adverse CV events when antihypertensive medications are taken at night rather than in the morning (e.g., NEJM JW Gen Med Jan 15 2019 and Eur Heart J 2020; 41:4565), but those trials have been controversial.

British researchers randomized 21,000 adults with treated hypertension to take their usual daily medications either in the morning (between 6 AM and 10 AM) or at night (between 8 PM and midnight). Participants completed periodic online questionnaires about their adherence, medica…