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Importance of Blood Pressure Control Over a 24-Hour Period

BACKGROUND: The circadian rhythm of blood pressure (BP) is associated with a high span during the awake period and a low span during the sleep period. Of interest is that cardiovascular (CV) events occur more frequently in the early morning period, the time when BP and heart rate rise steeply. OBJEC...

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Autor principal: White, William B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2007
Materias:
Cea
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437563/
https://www.ncbi.nlm.nih.gov/pubmed/17970615
http://dx.doi.org/10.18553/jmcp.2007.13.s8-b.34
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author White, William B.
author_facet White, William B.
author_sort White, William B.
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description BACKGROUND: The circadian rhythm of blood pressure (BP) is associated with a high span during the awake period and a low span during the sleep period. Of interest is that cardiovascular (CV) events occur more frequently in the early morning period, the time when BP and heart rate rise steeply. OBJECTIVES: To provide an overview of circadian BP and its correlation with adverse clinical outcomes and to discuss strategies for optimizing BP control over 24 hours. SUMMARY: Patients who have an excessive morning surge in BP and those who lack the normal nocturnal BP fall (nondippers) have been shown to have an excessive incidence of strokes, heart failure, and other CV events. While there are numerous pathophysiologic mechanisms underlying abnormalities in the 24-hour BP profile, including abnormalities in sympathetic nervous system activity, salt and volume balance, and activation of the renin-angiotensin aldosterone system, for many patients the mechanisms remain unclear. Nevertheless, several of these known abnormalities can be modified by clinical interventions, including proper timing of antihypertensive drug therapy and use of classes of antihypertensives for which a substrate exists to induce a pharmacologic effect. It is particularly important to use therapies that will provide control throughout a 24-hour dosing interval. RESULTS: While interventional strategies have not yet been shown to alter clinical outcomes, it is important to be cognizant of their physiologic basis and take them into consideration when making decisions regarding appropriate antihypertensive therapy.
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spelling pubmed-104375632023-08-21 Importance of Blood Pressure Control Over a 24-Hour Period White, William B. J Manag Care Pharm Cea BACKGROUND: The circadian rhythm of blood pressure (BP) is associated with a high span during the awake period and a low span during the sleep period. Of interest is that cardiovascular (CV) events occur more frequently in the early morning period, the time when BP and heart rate rise steeply. OBJECTIVES: To provide an overview of circadian BP and its correlation with adverse clinical outcomes and to discuss strategies for optimizing BP control over 24 hours. SUMMARY: Patients who have an excessive morning surge in BP and those who lack the normal nocturnal BP fall (nondippers) have been shown to have an excessive incidence of strokes, heart failure, and other CV events. While there are numerous pathophysiologic mechanisms underlying abnormalities in the 24-hour BP profile, including abnormalities in sympathetic nervous system activity, salt and volume balance, and activation of the renin-angiotensin aldosterone system, for many patients the mechanisms remain unclear. Nevertheless, several of these known abnormalities can be modified by clinical interventions, including proper timing of antihypertensive drug therapy and use of classes of antihypertensives for which a substrate exists to induce a pharmacologic effect. It is particularly important to use therapies that will provide control throughout a 24-hour dosing interval. RESULTS: While interventional strategies have not yet been shown to alter clinical outcomes, it is important to be cognizant of their physiologic basis and take them into consideration when making decisions regarding appropriate antihypertensive therapy. Academy of Managed Care Pharmacy 2007-10 /pmc/articles/PMC10437563/ /pubmed/17970615 http://dx.doi.org/10.18553/jmcp.2007.13.s8-b.34 Text en Copyright © 2007, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Cea
White, William B.
Importance of Blood Pressure Control Over a 24-Hour Period
title Importance of Blood Pressure Control Over a 24-Hour Period
title_full Importance of Blood Pressure Control Over a 24-Hour Period
title_fullStr Importance of Blood Pressure Control Over a 24-Hour Period
title_full_unstemmed Importance of Blood Pressure Control Over a 24-Hour Period
title_short Importance of Blood Pressure Control Over a 24-Hour Period
title_sort importance of blood pressure control over a 24-hour period
topic Cea
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437563/
https://www.ncbi.nlm.nih.gov/pubmed/17970615
http://dx.doi.org/10.18553/jmcp.2007.13.s8-b.34
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