Pragmatic Trials Collaborative
Measuring What Matters
Completed Trials
Summary
Older adults who are frail, or medically complex, are under-represented in the trials that guide their care. This is problematic given the risks and benefits of our treatments could be very different in this population. To supplement the findings of the BedMed trial, we ran a separate randomized trial of antihypertensive medication timing (N = 776; 320 primary outcomes) in residents of 13 Alberta continuing care facilities (nursing homes) who were being treated for hypertension. Similar to the main BedMed trial we found bedtime use of antihypertensive medications, compared to conventional morning use, to convey neither risk, in terms of potential hypotensive or ischemic adverse effects, nor benefit, in terms of a mortality-driven composite of all-cause death or major cardiovascular events.
Bottom Line
In frail older adults, administration time (bedtime versus morning) did not influence the risks or benefits of blood-pressure lowering medication. As in younger and less medically complex individuals, the timing of blood pressure medication in frail older adults can likely be tailored to individual patient circumstances and preferences.
Trial Details & Data Access
