Document Detail


Circadian Rhythms in Blood Pressure Regulation and Optimization of Hypertension Treatment With ACE Inhibitor and ARB Medications.
MedLine Citation:
PMID:  20930708     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Specific features of the 24 h-blood pressure (BP) pattern are linked to the progressive injury of target tissues and risk of cardiac and cerebrovascular events. Studies have consistently shown an association between blunted asleep BP decline and increased incidence of fatal and nonfatal cardiovascular events. Thus, there is growing interest in how to achieve better BP control during nighttime sleep in addition to during daytime activity, according to the particular requirements of each hypertension patient. One approach takes into consideration the endogenous circadian rhythm-determinants of the 24-h BP pattern, especially, the prominent day-night variation of the renin-angiotensin-aldosterone system, which activates during nighttime sleep. A series of clinical studies have demonstrated a different effect of the angiotensin-converting enzyme (ACE) inhibitors benazepril, captopril, enalapril, lisinopril, perindopril, quinapril, ramipril, spirapril, and trandolapril when routinely ingested in the morning vs. the evening. In most cases, the evening schedule exerts a more marked effect on the asleep than awake BP means. Similarly, a once-daily evening, in comparison to morning, ingestion schedule of the angiotensin receptor blockers (ARBs) irbesartan, olmesartan, telmisartan, and valsartan exerts greater therapeutic effect on asleep BP, plus significant increase in the sleep-time relative BP decline, with normalization of the circadian BP profile toward a more dipping pattern, independent of drug terminal half-life. Chronotherapy, the timing of treatment to body rhythms, is a cost-effective means of both individualizing and optimizing the treatment of hypertension through normalization of the 24-h BP level and profile, and it may constitute an effective option to reduce cardiovascular risk.American Journal of Hypertension (2011). doi:10.1038/ajh.2010.217.
Authors:
Ramón C Hermida; Diana E Ayala; José R Fernández; Francesco Portaluppi; Fabio Fabbian; Michael H Smolensky
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Publication Detail:
Type:  Journal Article     Date:  2010-10-07
Journal Detail:
Title:  American journal of hypertension     Volume:  24     ISSN:  1879-1905     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-91     Citation Subset:  IM    
Affiliation:
Bioengineering and Chronobiology Laboratories, University of Vigo, Campus Universitario, Vigo, Spain.
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