Circadian variations in blood pressure : implications for chronotherapeutics

Détails

ID Serval
serval:BIB_10AB62CE8EB2
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Circadian variations in blood pressure : implications for chronotherapeutics
Périodique
American Journal of Cardiovascular Drugs
Auteur(s)
Hasler  C., Burnier  M.
ISSN
1175-3277 (Print)
Statut éditorial
Publié
Date de publication
2005
Volume
5
Numéro
1
Pages
7-15
Notes
Journal Article
Review
Résumé
The management of hypertensive patients usually ignores or gives little credit to the biologic rhythms inherent to the disease process and their potential clinical implications. The development of ambulatory blood pressure monitoring and the rapidly growing popularity of home blood pressure measurements by patients have now generated a series of new clinical questions that are directly linked to the chronobiology of the cardiovascular system, such as the clinical interpretation of a blunted nocturnal fall in blood pressure or the difficulty of achieving adequate blood pressure control in the morning. Today, there is growing evidence that night-time blood pressure, and particularly the absence of a decrease in sleep blood pressure, contributes to the occurrence of target organ damages, and that the early morning rise in blood pressure increases the risk of developing cardiovascular events, including stroke, perhaps independently of 24-hour blood pressure levels. On the basis of these observations, it may be necessary to reconsider the way antihypertensive drugs are prescribed in order to obtain smooth, 24-hour blood pressure control, respecting the circadian pattern of blood pressure. Several approaches exist, including the use of drugs that lower blood pressure around the clock and respect the diurnal rhythm. Preliminary studies performed with such agents have provided interesting results. However, there is a clear need for large clinical trials demonstrating the clinical superiority of this approach. In any case, a better understanding of the importance of the circadian variations of blood pressure could certainly have a major impact on our view of the therapeutic management of hypertensive patients.
Mots-clé
Antihypertensive Agents/administration & dosage/therapeutic use Blood Pressure/*physiology *Chronotherapy *Circadian Rhythm Clinical Trials Drug Administration Schedule Humans Hypertension/drug therapy Time Factors
Pubmed
Création de la notice
25/01/2008 13:56
Dernière modification de la notice
20/08/2019 13:37
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