Condition category
Circulatory System
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
Treatment in Morning versus Evening (TIME) is a study to compare the treatment for high blood pressure using hypertensive drugs given in the evening with the usual morning medication. This is done using an online system to record any side effects or changes due to the change in their medication. This automated system has worked well in our initial phase of this study with good patient response. Record-linkage to hospitalisations and deaths will be carried out and events monitored. Heart attack, stroke or death will be recorded and analysed to see if the timing of the medication has any impact.

Who can participate?
People who are already taking antihypertensive medication in usual care

What does the study involve?
Participants take part by registering on a secure, study-specific website. Those who are eligible are randomly allocated to continue taking medication at their usual time (usually morning) or to switch to taking medication in the evening. Participants receive regular emails with simple links to record responses to track progress. Participants, people on their behalf, or GPs can record any side effects at any time online. Participants are followed up for 4 years.

What are the possible benefits and risks of participating?
Taking hypertensive medication in the evening may reduce the number of heart attack or stroke compared with usual morning dosing, and so is potentially of benefit to all hypertensive patients in the future. There are no known risks for patients taking part in the study.

Where is the study run from?
The study is sponsored by the University of Dundee, UK and run from the Medicines Monitoring Unit (MEMO) within this. The study is internet based and participants can be recruited from across the UK. They will be recruited from general practices, hospitals or by social media.

When is the study starting and how long is it expected to run for?
August 2011 to May 2019

Who is funding the study?
British Heart Foundation (UK)

Who is the main contact?
Ms Wendy Saywood

Trial website

Contact information



Primary contact

Ms Geraldine Mackle


Contact details

Dept of Clinical Pharmacology
Division of Medicine and Therapeutics
Level 7
Ninewells Avenue
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Treatment In Morning versus Evening: an observational study



Study hypothesis

A trial comparing evening dosing of usual antihypertensive therapy with conventional morning dose is proposed.

Ethics approval

East of Scotland Research Ethics Service (EoSRES) REC 1; 28/05/2011 (approval for the pilot study), 26/05/2014 (approval to move on to full study); ref. 11/AL/0309

Study design

Randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet


Topic: Primary Care, Cardiovascular disease; Subtopic: Other Primary Care, Cardiovascular (all Subtopics); Disease: All Diseases, Other


Timing of medication switch: Subjects already taking hypertensive medication in usual care will be identified from collaborating practices and within secondary care clinics. Subjects will be invited to participate in the study by registering on a study website. Registered subjects who meet the inclusion criteria will be randomised to continue taking medicine at their usual time (most often in the morning) or to switch to taking medication in the evening (or morning if evening is their usual time).

Intervention type



Not Applicable

Drug names

Primary outcome measure

The Anti Platelet Trialists' Collaboration: composite endpoint of non-fatal myocardial infarction, non-fatal stroke or vascular death.

Secondary outcome measures

1. Each component of the primary endpoint
2. Hospitalisation for non-fatal stroke
3. Hospitalisation for non-fatal MI
4. Vascular death
5. All-cause mortality
6. Hospitalisation or death from congestive heart failure.

1. Adherence to the evening dosing regimen vs morning (patient reported) with particular reference to patients taking diuretic therapy.
2. Patient reported and hospitalised adverse events in the morning versus evening groups will be compared. In particular falls and fractures will be recorded.
3. Home BP readings taken by a subset of patients will be compared between morning & evening dosing.
4. An additional proposed substudy is a telephone administered cognitive function assessment to compare patients on morning and evening dosing.

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Both diagnosed and treated for hypertension (all forms) with at least one antihypertensive drug
2. Aged above 18 years
3. Have a valid email address

Participant type


Age group




Target number of participants

Proposed following AM09: >20,000; Actual number recruited to date: 20,860 (AM09 (REC ref AM11): Approved 22/12/2015)

Participant exclusion criteria

1. Subjects who take twice daily antihypertensive therapy.
2. Subjects who work shift patterns that include a night shift.
3. Subjects who unwilling to consent to:
3.1. Follow up
3.2. Provide a surrogate to be contacted and/or
3.3. Give consent for their family practice to release follow up clinical data
3.4. To have their physical case records abstracted if required
3.5. To have their electronic case records searched and abstracted if required
3.6. To allow their consent from to be copied to authorities from whom the study team is requesting medical data
4. Those participating in another clinical trial or who have done in the last 3 months

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Ninewells Hospital and Medical School
United Kingdom

Sponsor information


NHS Tayside (UK)

Sponsor details

R&D Office
Level 9
Ninewells Hospital and Medical School
Ninewells Avenue
United Kingdom

Sponsor type

Hospital/treatment centre



Funder type


Funder name

British Heart Foundation (BHF) (UK); Grant Codes: CS/14/1/30659

Alternative name(s)


Funding Body Type

private sector organisation

Funding Body Subtype

Trusts, charities, foundations (both public and private)


United Kingdom

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2016 protocol in:
2017 analysis of recruitment, retention and follow-up rates in: (added 18/03/2020)
2018 substudy protocol in:

Publication citations

Additional files

Editorial Notes

18/03/2020: The following changes have been made: 1. Publication reference added. 2. The overall trial end date has been changed from 31/05/2019 to 03/04/2021. 11/06/2018: Publication reference added. 23/08/2016: The following changes were made to the trial record: 1. The overall trial end date was changed from 04/07/2016 to 31/05/2019. 2. The target number of participants was changed from 'Planned Sample Size: 10269; UK Sample Size: 10269' to 'Proposed following AM09: >20,000; Actual number recruited to date: 20,860 (AM09 (REC ref AM11): Approved 22/12/2015)'. 10/02/2016: Publication reference added.