Morning vs. bedtime telmisartan effects on daily blood pressure and exercise response in people with diabetes and high blood pressure

In diabetic hypertensive patients, bedtime telmisartan improved nocturnal blood pressure control, while morning dosing better blunted exercise-related blood pressure rises.

This randomized cross-over trial in 40 diabetic hypertensive patients compared telmisartan 40 mg taken in the morning versus at bedtime for 8 weeks each with ambulatory blood pressure and treadmill testing, finding lower night-time systolic and diastolic pressure with bedtime dosing and lower exercise-induced blood pressure increases with morning dosing.

The evidence comes from a small short-duration cross-over study, so the tradeoff between nocturnal and exercise blood pressure effects was shown without longer-term outcome data.