No variation seen: Evening vs. morning dosing of blood pressure medication

Two trials presented at ESC Congress 2024 found no significant benefits of evening versus morning blood pressure (BP)-lowering medication administration.

The BedMed trial, involving Canadian primary-care patients, compared morning and bedtime dosing of antihypertensives. Over 4.6 years, the primary outcome, major adverse cardiovascular events (MACE), was 9.7% for the bedtime group and 10.3% for the morning group (adjusted HR 0.96; 95% CI 0.77–1.19; p=0.70). Safety outcomes and hospitalizations were similar.

The BedMed-Frail trial, with elderly Canadian continuing care residents, showed MACE rates of 40.6% for the bedtime group and 41.9% for the morning group (adjusted HR 0.88; 95% CI 0.71–1.11; p=0.28). However, unplanned hospitalizations were lower in the bedtime group (HR 0.74; 95% CI 0.57–0.96; p=0.02).

Both studies were funded by Canadian research grants and presented at ESC Congress 2024.