Blood pressure medication works at any time of day

Blood pressure lowering medicines work equally well whether you take them in the morning or evening, according to new research.


Until now, research has indicated that it may be best to take blood pressure medicines in the evening. Now, a large trial has shown that the medicines work equally well whether you take them in the morning or evening, meaning you can take them at the time that suits you best. 

Over 20 000 people took part in the TIME (Treatment in Morning versus Evening) trial, who were all taking at least one medicine to lower their blood pressure. Half of those taking part were asked to take their medicines in the morning and half were asked to take them in the evening. The two groups were followed for an average of five years, at the end of which, there was no difference in the number of people who had a heart attack, stroke or died: 362 (3.4%) in the evening dosing group and 390 (3.7%) in the morning group. 

The lead investigator of the trial, Professor Tom Macdonald, Clinical Professor at the University of Dundee, said “People with high blood pressure should take their regular antihypertensive medications at a time of day that is convenient for them and minimises any undesirable effects.”

High blood pressure is a major risk factor for heart attacks, strokes and other diseases, and taking blood pressure medicines every day is an essential part of lowering that risk. Night-time blood pressure is a better predictor of serious events than daytime blood pressure, and there has been a suggestion that taking medicines in the evening reduces night time blood pressure more than taking it in the morning. TIME is the largest trial on this topic and shows it makes no meaningful difference to the risk of serious illness.  

Professor Williams, Trustee of Blood Pressure UK and member of the steering committee for the TIME trial said: “This is a study of huge practical importance. There has been much controversy and uncertainty over a simple question affecting hundreds of millions of people world-wide; notably, is taking blood pressure tablets in the evening better than taking them in the morning, in terms of protecting patients with high blood pressure from heart disease and stroke?

“The TIME study is the definitive randomised controlled trial, and the answer is no. Patients should take their tablets when they are most likely to remember to take them; the timing does not matter.”

The research was funded by the British Heart Foundation and presented this August at the European Society of Cardiology (ESC) Congress in Barcelona. 

Nirmala Markandu, Hypertension Nurse Specialist at Blood Pressure UK says: "This is very helpful information for the millions of people who take blood pressure medicines as not sticking to them is a big barrier to preventing heart attacks and strokes. This study means people can choose the time of day that works best for them and get into a routine they can stick to. We still advise taking your medicines at the same time each day, whether that’s morning or evening."

See the press release from the ESC.