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Titolo:
Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate
Autore:
White, WB;
Indirizzi:
Univ Connecticut, Sch Med, Sect Hypertens & Clin Pharmacol, Farmington, CT06030 USA Univ Connecticut Farmington CT USA 06030 armacol, Farmington, CT06030 USA
Titolo Testata:
BLOOD PRESSURE MONITORING
fascicolo: 2, volume: 6, anno: 2001,
pagine: 63 - 72
SICI:
1359-5237(200104)6:2<63:CRATIF>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; SUDDEN CARDIAC DEATH; CORONARY-ARTERY DISEASE; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; LEFT-VENTRICULAR HYPERTROPHY; ACUTE ISCHEMIC STROKE; CIRCADIAN VARIATION; DIURNAL-VARIATION; PLATELET AGGREGABILITY; ESSENTIAL-HYPERTENSION;
Keywords:
chronotherapeutics; early morning blood pressure surge; antihypertensive therapy; circadian rhythms; calcium antagonists; angiotensin II receptor blockers; beta-blockers;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
103
Recensione:
Indirizzi per estratti:
Indirizzo: White, WB Univ Connecticut, Sch Med, Sect Hypertens & Clin Pharmacol, 263 FarmingtonAve, Farmington, CT 06030 USA Univ Connecticut 263 Farmington AveFarmington CT USA 06030 USA
Citazione:
W.B. White, "Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate", BL PRESS M, 6(2), 2001, pp. 63-72

Abstract

The incidence of most adverse cardiovascular events appears to follow a circadian pattern, reaching a peak in the morning shortly after wakening and arising. The activities of many physiologic parameters, including hemodynamic, hematologic and humoral factors, also fluctuate in a cyclical manner over the 24 h, It has been suggested that, during the post-awakening hours, the phases of these cycles synchronize to create an environment that predisposes to atherosclerotic plaque rupture and thrombosis in susceptible individuals, thereby accounting for the heightened cardiovascular risk at this time of day. Blood pressure and heart rate are part of this physiologic process, following a clear circadian rhythm characterized by a fall during sleepand a sharp rise upon awakening. This so-called 'morning surge' in blood pressure may act as a trigger for cardiovascular events, including myocardial infarction and stroke. The clinical implication of these observations is that antihypertensive therapy should provide blood pressure control over the entire interval between doses. For agents taken once daily in the morning, the time of trough plasma drug level (and lowest pharmacodynamic effect) will often coincide with the early morning surge in blood pressure and heart rate. For these reasons, chronotherapeutic formulations of drugs and intrinsically long-acting antihypertensive agents provide the most logical approach to the treatment of hypertensive patients since they provide 24 h blood pressure control from a single daily dose as well as attenuating the early morning rise in blood pressure (and in some instances heart rate). (C) 2001 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 00:47:20