A Canadian trial published in JAMA involving 3,200 primary care patients (56.4% female; median age, 67 years) evaluated the timing of antihypertensive medication administration and found no difference in morning vs bedtime dosing. Over a median follow-up of 4.6 years, bedtime dosing was found to be safe but offered no additional cardiovascular benefit. Rates of major cardiovascular events or death were similar between groups (2.3 vs 2.4 per 100 patient-years; adjusted hazard ratio 0.96, 95% confidence interval 0.77–1.19). These findings challenge the hypothesis that evening dosing may improve outcomes. The primary outcome was time to first occurrence of all-cause death or hospitalization/emergency department visit for stroke, acute coronary syndrome, or heart failure. Researchers also found no difference in visual, cognitive, or fall- and/or fracture-related safety outcomes.
Your choice: Medication adherence can be highly variable among patients and over time, especially with medications like antihypertensives that are taken long term. By encouraging patients to take their meds at a time of day that is more convenient or easier to remember, adherence could increase, the authors say.