Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension

Background. Refractory arterial hypertension (RAH) is frequently associated to a non-dipping blood pressure (BP) pattern; this profile has been shown to have a worse clinical prognosis. It is a common clinical practice that patients receive anti-hypertensive medication preferentially in the morning....

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Autores: Almirall, J, Comas, L, Martínez-Ocaña, JC, Roca, S, Arnau, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:dnet:r-i3pt______::36971a0a7d00c12c03644153ad18c72a
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/7039
Access Level:acceso abierto
Palabra clave:ambulatory blood pressure monitoring
chronotherapy
circadian rhythm
non-dipper
refractory hypertension
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spelling Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertensionAlmirall, JComas, LMartínez-Ocaña, JCRoca, SArnau, Aambulatory blood pressure monitoringchronotherapycircadian rhythmnon-dipperrefractory hypertensionBackground. Refractory arterial hypertension (RAH) is frequently associated to a non-dipping blood pressure (BP) pattern; this profile has been shown to have a worse clinical prognosis. It is a common clinical practice that patients receive anti-hypertensive medication preferentially in the morning. Non-dipping could be related to the timing of anti-hypertensive drug administration. We analysed whether switching anti-hypertensive medication to bedtime could improve BP control in non-dipper patients with RAH. Methods. Twenty-seven consecutive patients with RAH and non-dipper or riser BP pattern on ambulatory blood pressure (ABP) monitoring were studied before and after 6 weeks of a change in the timing of anti-hypertensive medications. The intervention consisted of shifting all non-diuretic anti-hypertensive drugs from morning to evening, maintaining the same drugs at the same doses. A parallel group of 12 consecutive patients with similar characteristics and no changes in the therapeutic regimen formed the control group. Results. There were 59% women, mean age 65.7+/-8.4 years. They were treated with 4+/-0.7 anti-hypertensive drugs, 90% administered in the morning. At baseline, diurnal and nocturnal ABP averaged 141.6+/-10.6/81.5+/-9.3 and 141.7+/-11/78+/-8.8, respectively. After the drug shift, mean diurnal and nocturnal ABP was 140.5+/-10.4/80.5+/-9.6 and 135.7+/-12.5/73.8+/-9.3 (P=0.005 and 0.04 for systolic and diastolic ABP), 15% of the patients restored a normal ABP circadian rhythm. No changes were observed in the control group. Conclusion. In non-dipper or riser patients with RAH, changing the timing of anti-hypertensive medication to the evening could improve BP control.OXFORD UNIV PRESS2012info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/7039NEPHROLOGY DIALYSIS TRANSPLANTATIONISSN: 09310509ISSNe: 14602385reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:dnet:r-i3pt______::36971a0a7d00c12c03644153ad18c72a2026-06-21T15:30:37Z
dc.title.none.fl_str_mv Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
title Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
spellingShingle Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
Almirall, J
ambulatory blood pressure monitoring
chronotherapy
circadian rhythm
non-dipper
refractory hypertension
title_short Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
title_full Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
title_fullStr Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
title_full_unstemmed Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
title_sort Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension
dc.creator.none.fl_str_mv Almirall, J
Comas, L
Martínez-Ocaña, JC
Roca, S
Arnau, A
author Almirall, J
author_facet Almirall, J
Comas, L
Martínez-Ocaña, JC
Roca, S
Arnau, A
author_role author
author2 Comas, L
Martínez-Ocaña, JC
Roca, S
Arnau, A
author2_role author
author
author
author
dc.subject.none.fl_str_mv ambulatory blood pressure monitoring
chronotherapy
circadian rhythm
non-dipper
refractory hypertension
topic ambulatory blood pressure monitoring
chronotherapy
circadian rhythm
non-dipper
refractory hypertension
description Background. Refractory arterial hypertension (RAH) is frequently associated to a non-dipping blood pressure (BP) pattern; this profile has been shown to have a worse clinical prognosis. It is a common clinical practice that patients receive anti-hypertensive medication preferentially in the morning. Non-dipping could be related to the timing of anti-hypertensive drug administration. We analysed whether switching anti-hypertensive medication to bedtime could improve BP control in non-dipper patients with RAH. Methods. Twenty-seven consecutive patients with RAH and non-dipper or riser BP pattern on ambulatory blood pressure (ABP) monitoring were studied before and after 6 weeks of a change in the timing of anti-hypertensive medications. The intervention consisted of shifting all non-diuretic anti-hypertensive drugs from morning to evening, maintaining the same drugs at the same doses. A parallel group of 12 consecutive patients with similar characteristics and no changes in the therapeutic regimen formed the control group. Results. There were 59% women, mean age 65.7+/-8.4 years. They were treated with 4+/-0.7 anti-hypertensive drugs, 90% administered in the morning. At baseline, diurnal and nocturnal ABP averaged 141.6+/-10.6/81.5+/-9.3 and 141.7+/-11/78+/-8.8, respectively. After the drug shift, mean diurnal and nocturnal ABP was 140.5+/-10.4/80.5+/-9.6 and 135.7+/-12.5/73.8+/-9.3 (P=0.005 and 0.04 for systolic and diastolic ABP), 15% of the patients restored a normal ABP circadian rhythm. No changes were observed in the control group. Conclusion. In non-dipper or riser patients with RAH, changing the timing of anti-hypertensive medication to the evening could improve BP control.
publishDate 2012
dc.date.none.fl_str_mv 2012
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/7039
url https://i3pt.portalinvestigacion.com/publicaciones/7039
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv NEPHROLOGY DIALYSIS TRANSPLANTATION
ISSN: 09310509
ISSNe: 14602385
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
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collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
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