TIME Study
Hypertension Treatment in Morning versus Evening
Objective:
To determine whether evening dosing of antihypertensive medication improves major cardiovascular outcomes compared to morning dosing in patients with hypertension.
Study Design:
- Prospective, pragmatic, decentralized, parallel-group study.
- Conducted in the UK.
- Randomized 1:1 to morning (0600–1000 h) or evening (2000–0000 h) dosing of antihypertensive medications.
Participants:
- Enrolled: 21,104 adults (≥18 years) with hypertension.
- Mean Age: 65.1 years (SD 9.3).
- Gender: 57.5% men, 42.5% women.
- Ethnicity: 90.5% White, 0.5% Black/African/Caribbean, 7.8% unreported.
- Previous CVD: 13.0%.
Primary Endpoint:
- Composite of vascular death, non-fatal myocardial infarction, or non-fatal stroke.
- Assessed as time to first event in the intention-to-treat population.
Results:
- Median Follow-up: 5.2 years (IQR 4.9–5.7).
- Primary Endpoint Events:
- Evening dosing: 362 (3.4%), 0.69 events per 100 patient-years.
- Morning dosing: 390 (3.7%), 0.72 events per 100 patient-years.
- Hazard Ratio (Evening vs. Morning): 0.95 (95% CI 0.83–1.10; p=0.53).
- Safety: No concerns identified.
Conclusion:
Evening dosing of antihypertensive medication did not differ from morning dosing in terms of major cardiovascular outcomes. Patients can take their antihypertensive medications at a convenient time that minimizes undesirable effects.