medwireNews: The TIME study finds no difference between morning and evening administration of antihypertensive medications in terms of preventing major adverse cardiovascular events (MACE).
As reported in The Lancet, Thomas MacDonald (University of Dundee, UK) and colleagues recruited 21,104 people (13% had diabetes) who were taking at least one antihypertensive to the open-label, pragmatic TIME trial, in which they were randomly assigned to take their medications either in the morning or the evening.
During a median follow-up of 5.2 years, MACE occurred in 3.7% of participants assigned to morning dosing and 3.4% of those in the evening group, with no significant difference between the two, and secondary endpoints were in line with the primary outcome.
The findings are contrary to trials such as the Hygia Chronotherapy Trial, which found evidence to support evening dosing, but the authors of a commentary linked to the TIME trial highlight the “concerns surrounding the design, conduct, and results” of these previous studies.
For now, Husam Salah and Jawahar Mehta, both from University of Arkansas for Medical Sciences in Little Rock, USA, believe that TIME supplies “reasonably strong evidence” that the timing of antihypertensive administration “should be a shared decision-making process between patients and clinicians.”
And they add that the ongoing BedMed (NCT02990663) and BedMed-Frail (NCT04054648) trials, both due to complete in 2023, should add more information.
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Lancet 2022; doi:10.1016/S0140-6736(22)01786-X
Lancet 2022; doi:10.1016/S0140-6736(22)01900-6