CORNELISSEN, Germaine, Alena HAVELKOVÁ, Jarmila SIEGELOVÁ, D. GUBIN, L. A. BEATY and K. OTSUKA. Chronotherapy of Blood Pressure: Beyond Comparing Morning vs. Evening Dosing. Online. In Cornélissen G., Siegelová J., Pohanka M., Dobšák P. Noninvasive methods in cardiology 2023. Brno: Masaryk University Press, 2023, p. 9-25. ISBN 978-80-280-0441-5.
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Basic information
Original name Chronotherapy of Blood Pressure: Beyond Comparing Morning vs. Evening Dosing
Authors CORNELISSEN, Germaine, Alena HAVELKOVÁ (203 Czech Republic, belonging to the institution), Jarmila SIEGELOVÁ (203 Czech Republic, belonging to the institution), D. GUBIN, L. A. BEATY and K. OTSUKA.
Edition Brno, Noninvasive methods in cardiology 2023, p. 9-25, 17 pp. 2023.
Publisher Masaryk University Press
Other information
Original language English
Type of outcome Proceedings paper
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Publication form electronic version available online
WWW URL
RIV identification code RIV/00216224:14110/23:00132568
Organization unit Faculty of Medicine
ISBN 978-80-280-0441-5
Keywords in English Chronotherapy; Blood Pressur; Morning Dosing; Evening Dosing
Tags rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 5/4/2024 09:01.
Abstract
The day-night ratio (DNR) of blood pressure (BP) is the index currently used most often by those relying on ambulatory blood pressure monitoring (ABPM) for the diagnosis and prognosis of hypertensive patients. It is also used as a gauge of the response to antihypertensive medication. Herein, we illustrate how ongoing debates regarding the relative merits of administering anti-hypertensive drugs in the morning or evening are misguided by trying to answer the wrong question. We review evidence showing that cardiovascular disease risk tends to be more strongly associated with a reverse dipping pattern of BP than with a nondipping pattern. We also offer some explanation why extreme dipping may be associated with increased risk in the elderly while it is protective in younger populations. Based on abstract models, we demonstrate that reliance on the circadian amplitude and phase interpreted in the light of chronobiologic reference values qualified by gender and age constitutes a more robust and more reliable approach than the classification in terms of dipping based on the DNR. We conclude by redefining the question to be answered in future clinical trials, leading to the suggestion of chronotherapy protocols aimed at a personalized treatment of BP disorders.
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