JAMA

Does timing of BP meds impact cardiovascular outcomes?

May 14, 2025

Administering antihypertensive medications at bedtime vs. morning didn’t significantly affect cardiovascular outcomes or safety in adults with hypertension in a randomized trial. The findings suggest dosing can be tailored to patient preference and convenience.

Study details: In the pragmatic, randomized, open-label BedMed trial, 3,357 Canadian primary care patients with hypertension were randomized to take all once-daily antihypertensive medications either in the morning or at bedtime. The primary outcome was a composite of all-cause death and major cardiovascular events (MI, stroke, CHF hospitalization, or coronary revascularization), with a median follow-up of 5.2 years.

Results: Bedtime administration of antihypertensive medications had no effect on death or major cardiovascular events (2.3 vs. 2.4 per 100 patient-years; adjusted hazard ratio, 0.96; 95% confidence interval [CI], 0.77-1.19; P = 0.70). There weren’t significant differences in individual components of the primary outcome, all-cause hospitalizations/ED visits, or safety outcomes, including falls, fractures, new glaucoma diagnoses, or cognitive decline.

Source:

Garrison SR, et al. (2025, May 12). JAMA. Antihypertensive Medication Timing and Cardiovascular Events and Death: The BedMed Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40354045/