You may be asked to change the time you take your blood pressure medication. You’ll be randomly assigned to take those medications (as tolerated) either in the morning or at bedtime for the duration of the study — up to 3 years. If you take medications at both times, you are still eligible to participate.

Which medications you use, and all other decisions regarding changes to these medications, will stay between you and your health care provider. If you need to change back to your original medication timing, you are able to do so. Whether you choose to participate or not will have no impact on your relationship with your healthcare team.

The study will involve these steps:

1. Call: 1-844-492-7570

   Our study staff will talk with you to see if the study is a good fit for you and answer any questions.

2. Consent

   Consent can be done through mail or online survey. The study team will also collect medical history questions from you over the phone.

3. Randomization

   1. You will be randomly placed into either the morning or evening group. You will record this on the “Medication Worksheet” at the back of this package, along with a list of your blood pressure medications.

   2. You might see your health care provider if you need to change the time of one or more medications.

4. Follow-ups

   The study team will call you one week later if there is the possibility of medication timing being changed. After this, follow-up interviews are at six weeks, six months, and every six months thereafter until the study is done. Interviews from month six onward are by phone or online survey if you prefer.

Wherever you are. Initial contact with the study team is by phone. Consent and follow up interviews can be done either by phone or online survey.

The study begins after you speak with the study team by phone. Please don’t change the time of day that you take your blood pressure medications before talking with your healthcare provider. Participation in this study is voluntary and you may withdraw at any time without having to give a reason.

One in five adult Canadians has high blood pressure. Whether or not we confirm benefit to bedtime prescribing, your participation will help answer an important question surrounding medications used by millions of people worldwide.

Morning medication use

According to previous research, it’s possible that there’s a higher risk of heart attack and stroke for those who take their blood pressure medications in the morning (compared to those who use them at bedtime). We don’t know if this is true, which is why we’re conducting this study.

Bedtime medication use

There are no established risks to using blood pressure pills at bedtime but we’re closely watching for three possibilities:

1. Best evidence suggests it’s not the case, but certain blood pressure pills might increase the number of overnight trips to the bathroom to urinate.
2. Having lower blood pressure overnight may lead to dizziness and potential for falls and fractures.
3. Lower blood pressures overnight might lead to reduced blood flow to the back of the eye in patients with glaucoma, and this may adversely affect vision. For this reason, those with glaucoma are excluded from participating.