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[Hypertension and circadian rhythm]

Satoshi Hoshide1, Kazuomi Kario1

  • 1Department of Sleep and Circadian Cardiology, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|January 21, 2014
PubMed

Insights

Abnormal blood pressure (BP) rhythms, like high sleep BP and morning surges, predict cardiovascular events in hypertension. Further research is needed to confirm if these BP rhythm abnormalities can guide treatment independently of average BP levels.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Circadian Biology

Context:

  • Ambulatory BP monitoring reveals abnormal circadian BP rhythms in hypertensive patients.
  • These rhythms include absent nocturnal BP fall, elevated sleep BP, and exaggerated morning BP surges.
  • These BP patterns are linked to target organ damage and cardiovascular events, irrespective of average BP levels.

Purpose:

  • To investigate whether abnormal circadian BP rhythms serve as an independent therapeutic target in hypertension.
  • To evaluate the potential of BP rhythm abnormalities as a biomarker for guiding antihypertensive treatment, beyond average BP values.

Summary:

  • Hypertensive patients with abnormal BP circadian rhythms face higher risks of cardiovascular events.
  • The clinical utility of targeting these BP rhythm abnormalities, independent of mean BP, remains uncertain.
  • Existing intervention studies provide insufficient evidence to establish abnormal BP rhythms as a distinct therapeutic target.

Impact:

  • Highlights the prognostic significance of BP circadian rhythm abnormalities in hypertension.
  • Underscores the need for further clinical trials to validate BP rhythm-based treatment strategies.
  • May inform future guidelines for personalized antihypertensive therapy based on circadian BP patterns.

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