Treatment In the Morning versus Evening (TIME study)

A large-scale trial is asking 10,269 people with high blood pressure to switch their medication from morning to evening to see if it prevents more heart attacks and strokes. The problem is that timing matters for blood pressure drugs, but no one knows for certain whether taking them at night reduces cardiovascular events better than the standard morning dose. Previous smaller studies have suggested a benefit, but the evidence is not definitive enough to change clinical guidelines. This trial aims to settle the question with a four-year follow-up, tracking hospitalisations and deaths through linked health records. If evening dosing proves superior, the change would be trivial for patients—swallowing a pill at a different time of day—but could meaningfully reduce the burden of heart disease and stroke across the UK population. The trial’s automated, web-based recruitment and follow-up system also demonstrates a low-cost model for running large pragmatic trials without requiring frequent clinic visits. If the result is negative, it will spare millions of people from an unnecessary change to their daily routine. Either way, the answer will be definitive.