Effect of morning or evening antihypertensive therapy on heart failure in community resident patients: Results of the TIME and BedMed Trials.

To evaluate the effect of morning or evening antihypertensive therapy on heart failure (HF), myocardial infarction, stroke and all-cause death in community resident patients in the TIME and BedMed trials, by study-level meta-analysis. These trials included 24,461 patients, experiencing 248 HFs, 371 myocardial infarctions, 331 strokes and 1,044 all-cause deaths. The pooled hazard ratio (HR) and 95% confidence interval (CI) between therapy groups were calculated for each event. For HF, myocardial infarction, stroke and all-cause death, the HRs (95%) CIs, P value, for evening versus morning therapy were 0.77 (0.60-0.99), P = 0.04, 1.02 (0.77-1.35), P = 0.91, 0.92 (0.74-1.14), P = 0.43, and 1.02 (0.90-1.14), P = 0.79, respectively. No heterogeneity was found for HF, stroke and all-cause death, and mild heterogeneity was observed for myocardial infarction. In the TIME and BedMed trials, compared to morning therapy, evening therapy was associated with a 23% lower risk of HF, whereas no difference was observed for other outcomes. This analysis of the TIME and BedMed trials evaluating community resident patients shows that, when compared to morning antihypertensive therapy, evening therapy was associated with a 23% lower risk of HF. CI confidence interval, HR hazard ratio.