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chronotherapy ambulatory blood pressure

Ramón C Hermida, Diana E Ayala, José R Fernández, Artemio Mojón, Michael H Smolensky
Diagnosis of hypertension-elevated blood pressure (BP) associated with increased cardiovascular disease (CVD) risk-and its management for decades have been based primarily on single time-of-day office BP measurements (OBPM) assumed representative of systolic (SBP) and diastolic BP (DBP) during the entire 24-hours span. Around-the-clock ambulatory blood pressure monitoring (ABPM), however, reveals BP undergoes 24-hours patterning characterized in normotensives and uncomplicated hypertensives by striking morning-time rise, 2 daytime peaks-one ~2-3 hours after awakening and the other early evening, small midafternoon nadir and 10-20% decline (BP dipping) in the asleep BP mean relative to the wake-time BP mean...
May 2018: European Journal of Clinical Investigation
Michael H Smolensky, Ramón C Hermida, Diana E Ayala, Artemio Mojón, José R Fernández
The bases for bedtime hypertension chronotherapy (BHCT) as superior chronoprevention against cardiovascular disease (CVD) are: (1) correlation between blood pressure (BP) and various risks is greater for ambulatory BP monitoring (ABPM) than office BP measurements (OBPM); (2) asleep BP mean is a better predictor of CVD risk than ABPM awake and 24-hour means and OBPM; and (3) targeting of asleep BP by BHCT with one or more conventional medications versus usual on-awakening therapy better reduces major and total CVD events...
October 2017: Heart Failure Clinics
Ramón C Hermida, Diana E Ayala, José R Fernández, Artemio Mojón, Juan J Crespo, María T Ríos, Michael H Smolensky
Consistent evidence of numerous studies substantiates the asleep blood pressure (BP) mean derived from ambulatory BP monitoring (ABPM) is both an independent and a stronger predictor of cardiovascular disease (CVD) risk than are daytime clinic BP measurements or the ABPM-determined awake or 24-hour BP means. Hence, cost-effective adequate control of sleep-time BP is of marked clinical relevance. Ingestion time, according to circadian rhythms, of hypertension medications of 6 different classes and their combinations significantly improves BP control, particularly sleep-time BP, and reduces adverse effects...
October 2017: Heart Failure Clinics
Jamie M Madden, Xia Li, Patricia M Kearney, Kate Tilling, Anthony P Fitzgerald
BACKGROUND: There are many examples of physiological processes that follow a circadian cycle and researchers are interested in alternative methods to illustrate and quantify this diurnal variation. Circadian blood pressure (BP) deserves additional attention given uncertainty relating to the prognostic significance of BP variability in relation to cardiovascular disease. However, the majority of studies exploring variability in ambulatory blood pressure monitoring (ABPM) collapse the data into single readings ignoring the temporal nature of the data...
2017: Emerging Themes in Epidemiology
Manuel T Velasquez, Srinivasan Beddhu, Ehsan Nobakht, Mahboob Rahman, Dominic S Raj
Hypertension is common in patients with chronic kidney disease (CKD) and is the most important modifiable risk factor for CKD progression and adverse cardiovascular events in these patients. Diagnosis and successful management of hypertension are critically dependent on accurate blood pressure (BP) measurement. This is most relevant to CKD patients, in whom BP control is difficult to achieve and in whom early antihypertensive treatment is imperative to prevent kidney and cardiovascular complications. Accumulated data indicate that ambulatory blood pressure monitoring (ABPM) is better in detecting hypertension than office BP measurement...
July 2016: KI Reports
Anne Marie O'Flynn, Emily Ho, Eamon Dolan, Ronan J Curtin, Patricia M Kearney
INTRODUCTION: The aim of this study was to examine the association of night-time systolic blood pressure (BP) with subclinical cardiac dysfunction measured by global longitudinal strain (GLS) and subclinical vascular damage measured by carotid intima-media thickness (CIMT) and carotid plaques. METHODS: GLS was measured by speckle-tracking analysis of echocardiogram images. CIMT was measured at the distal 1 cm of the common carotid artery. The presence of carotid plaques was recorded...
February 2017: Blood Pressure Monitoring
Ramón C Hermida, Diana E Ayala, Michael H Smolensky, José R Fernández, Artemio Mojón, Francesco Portaluppi
Correlation between blood pressure (BP) and target organ damage, vascular risk, and long-term patient prognosis is stronger for measurements derived from around-the-clock ambulatory BP monitoring (ABPM) than in-clinic daytime ones. Numerous studies consistently substantiate the asleep BP mean is both an independent and much better predictor of cardiovascular disease (CVD) risk than either the awake or 24 h means. Elevated sleep-time BP, i.e., sleep-time hypertension, which can only be diagnosed by around-the-clock ABPM, is much more common than suspected, not only in patients with sleep disorders, but, among others, in those who are elderly or have type 2 diabetes, chronic kidney disease, or resistant hypertension...
April 14, 2016: Sleep Medicine Reviews
Andi Kristanto, Randy Adiwinata, Silvia Suminto, Benny N Kurniawan, Finna Christianty, Robert Sinto
The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM)...
January 2016: Acta Medica Indonesiana
Ramón C Hermida
This article describes the rationale, objectives, design and conduct of the ambulatory blood pressure monitoring (ABPM)-based Hygia Project. Given the substantial evidence of the significantly better prognostic value of ABPM compared to clinic BP measurements, several international guidelines now propose ABPM as a requirement to confirm the office diagnosis of hypertension. Nonetheless, all previous ABPM outcome investigations, except the Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares study (MAPEC) study, relied upon only a single, low-reproducible 24 h ABPM assessment per participant done at study inclusion, thus precluding the opportunity to explore the potential reduction in cardiovascular disease (CVD) risk associated with modification of prognostic ABPM-derived parameters by hypertension therapy...
2016: Chronobiology International
Ramón C Hermida, Diana E Ayala, Michael H Smolensky, José R Fernández, Artemio Mojón, Francesco Portaluppi
Correlation between blood pressure (BP) and target organ damage, vascular risk and long-term patient prognosis is greater for measurements derived from around-the-clock ambulatory BP monitoring than in-clinic daytime ones. Numerous studies consistently substantiate the asleep BP mean is both an independent and a much better predictor of cardiovascular disease (CVD) risk than either the awake or 24 h means. Sleep-time hypertension is much more prevalent than suspected, not only in patients with sleep disorders, but also among those who are elderly or have type 2 diabetes, chronic kidney disease or resistant hypertension...
May 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Ramón C Hermida, Diana E Ayala
No abstract text is available yet for this article.
January 1, 2016: Medicina Clínica
M Bendersky
The blood pressure profile in most normo- and hypertensive subjects are currently known, as well as the impact their changes induced on the cardio- and cerebrovascular risk. Ambulatory blood pressure monitoring (ABPM) has contributed greatly to the knowledge of this parameter. It to correct the schedule of drug administration (chronotherapy) with changes in any component of the BP profile that have better correlation with risk. These include the nocturnal decrease and the morning BP surge. Investigations in this direction are still scarce, and multicenter studies need to be conducted that can answer the true preventive impact of such modifications...
July 2015: Hipertensión y Riesgo Vascular
Ingrid Prkacin, Diana Balenovic, Vesna Djermanovic-Dobrota, Iva Lukac, Petra Drazic, Iva-Klara Pranjic
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the continuous use of three antihypertensive agents in optimal dose, including diuretic, and lifestyle changes. According to data from United States of America and Europe, the prevalence ranges from 10 up to 30% in patients with hypertension. Numerous biological and lifestyle factors can contribute to the development of resistant hypertension: medications, volume overload, obesity, diabetes mellitus, older age, renal parenchymal and renovascular disease, primary aldosteronism, obstructive sleep apnea, pheochormocytoma, Cushing's syndrome, thyroid diseases, aortic coarctation...
April 2015: Materia Socio-medica
Paul M Stranges, Amy M Drew, Patricia Rafferty, Jerrica E Shuster, Amie D Brooks
OBJECTIVE: To review evidence for dosing antihypertensives at bedtime and possible cardiovascular risk reduction. DATA SOURCES: A PubMed, EMBASE, and Cochrane Controlled Trials database literature search (1990-September 2014) limited to human subjects was performed using the search terms hypertension, chronotherapy, ambulatory blood pressure, morning administration, evening administration, and antihypertensives. Additional references were identified from literature citations...
March 2015: Annals of Pharmacotherapy
Mei Cheng, Shu-Ling Cheng, Qing Zhang, He Jiang, Ji-Yan Cong, Xiao-Ying Zang, Yue Zhao
AIMS AND OBJECTIVES: To explore the effect of continuous nursing intervention guided by chronotherapeutics so as to provide the easy, noninvasive, effective and acceptable intervention for older hypertensive patients in the community. BACKGROUND: Many researchers studied the effect of administration at different times on blood pressure control and circadian rhythm. However, the individual administrative time was set ambiguously in previous studies. DESIGN: A semi-experimental study...
August 2014: Journal of Clinical Nursing
Ramón C Hermida, Michael H Smolensky, Diana E Ayala, José R Fernández, Ana Moyá, Juan J Crespo, Artemio Mojón, María T Ríos, Fabio Fabbian, Francesco Portaluppi
In chronic kidney disease (CKD), the prevalence of hypertension is very high, escalating with diminishing renal function. Typically, the diagnosis of hypertension and the clinical decisions regarding its treatment are based on daytime clinic blood pressure (BP) measurements. However, the correlation between BP level and target organ damage, cardiovascular risk and long-term prognosis is greater for ambulatory than clinic measurements. Moreover, evidence is consistent among numerous studies that the elevated risk and incidence of end-organ injury and fatal and non-fatal cardiovascular events are significantly associated with blunted night-time BP decline, and that the asleep BP better predicts cardiovascular events than either the awake or 24-h BP mean...
June 2014: Nephrology, Dialysis, Transplantation
Ramón C Hermida, Michael H Smolensky, Diana E Ayala, Francesco Portaluppi, Juan J Crespo, Fabio Fabbian, Erhard Haus, Roberto Manfredini, Artemio Mojón, Ana Moyá, Luis Piñeiro, María T Ríos, Alfonso Otero, Horia Balan, José R Fernández
Correlation between systolic (SBP) and diastolic (DBP) blood pressure (BP) level and target organ damage, cardiovascular disease (CVD) risk, and long-term prognosis is much greater for ambulatory BP monitoring (ABPM) than daytime office measurements. The 2013 ABPM guidelines specified herein are based on ABPM patient outcomes studies and constitute a substantial revision of current knowledge. The asleep SBP mean and sleep-time relative SBP decline are the most significant predictors of CVD events, both individually as well as jointly when combined with other ABPM-derived prognostic markers...
April 2013: Clínica e Investigación en Arteriosclerosis
Franz Halberg, Deborah Powell, Kuniaki Otsuka, Yoshihiko Watanabe, Larry A Beaty, Paul Rosch, Jerzy Czaplicki, Dewayne Hillman, Othild Schwartzkopff, Germaine Cornelissen
Chronobiology is the study of biological rhythms. Chronomics investigates interactions with environmental cycles in a genetically coded autoresonance of the biosphere with wrangling space and terrestrial weather. Analytical global and local methods applied to human blood pressure records of around-the-clock measurements covering decades detect physiological-physical interactions, a small yet measurable response to solar and terrestrial magnetism. The chronobiological and chronomic interpretation of ambulatory blood pressure monitoring (C-ABPM) records in the light of time-specified reference values derived from healthy peers matched by sex and age identify vascular variability anomalies (VVAs) for an assessment of cardio-, cerebro-, and renovascular disease risk...
August 1, 2013: American Journal of Physiology. Heart and Circulatory Physiology
Ramón C Hermida, Diana E Ayala, Michael H Smolensky, Artemio Mojón, José R Fernández, Juan J Crespo, Ana Moyá, María T Ríos, Francesco Portaluppi
In patients with chronic kidney disease (CKD), the prevalence of increased blood pressure during sleep and blunted sleep-time-relative blood pressure decline (a nondipper pattern) is very high and increases substantially with disease severity. Elevated blood pressure during sleep is the major criterion for the diagnoses of hypertension and inadequate therapeutic ambulatory blood pressure control in these patients. Substantial, clinically meaningful ingestion-time-dependent differences in the safety, efficacy, duration of action and/or effects on the 24 h blood pressure pattern of six different classes of hypertension medications and their combinations have been substantiated...
June 2013: Nature Reviews. Nephrology
Chakrapani Mahabala, Padmanabha Kamath, Unnikrishnan Bhaskaran, Narasimha D Pai, Aparna U Pai
Hypertension is a major independent risk factor for cardiovascular diseases. Management of hypertension is generally based on office blood pressure since it is easy to determine. Since casual blood pressure readings in the office are influenced by various factors, they do not represent basal blood pressure. Dipping of the blood pressure in the night is a normal physiological change that can be blunted by cardiovascular risk factors and the severity of hypertension. Nondipping pattern is associated with disease severity, left ventricular hypertrophy, increased proteinuria, secondary forms of hypertension, increased insulin resistance, and increased fibrinogen level...
2013: Vascular Health and Risk Management
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