Document Detail

Circadian variations in blood pressure : implications for chronotherapeutics.
MedLine Citation:
PMID:  15631533     Owner:  NLM     Status:  MEDLINE    
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.
Christopher Hassler; Michel Burnier
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of cardiovascular drugs : drugs, devices, and other interventions     Volume:  5     ISSN:  1175-3277     ISO Abbreviation:  Am J Cardiovasc Drugs     Publication Date:  2005  
Date Detail:
Created Date:  2005-01-05     Completed Date:  2005-04-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100967755     Medline TA:  Am J Cardiovasc Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  7-15     Citation Subset:  IM    
Division of Hypertension and Vascular Medicine, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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MeSH Terms
Antihypertensive Agents / administration & dosage,  therapeutic use
Blood Pressure / physiology*
Circadian Rhythm*
Clinical Trials as Topic
Drug Administration Schedule
Hypertension / drug therapy
Time Factors
Reg. No./Substance:
0/Antihypertensive Agents

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