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Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
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Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
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Related Experiment Video

Updated: Apr 12, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

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Resistant hypertension and chronotherapy.

Ingrid Prkacin1, Diana Balenovic2, Vesna Djermanovic-Dobrota1

  • 1Merkur University Hospital, Department of Internal Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia.

Materia Socio-Medica
|May 26, 2015
PubMed
Summary
This summary is machine-generated.

Resistant hypertension, uncontrolled blood pressure despite medication, affects 10-30% of hypertensive patients. Addressing underlying causes and optimizing treatment, including night-time blood pressure, is key for better outcomes.

Keywords:
chronotherapycircadian variationresistant hypertension

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Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Resistant hypertension (RH) is defined as uncontrolled blood pressure (BP) above 140/90 mmHg despite optimal doses of three antihypertensive agents and lifestyle changes.
  • Prevalence of RH ranges from 10-30% in hypertensive populations in the US and Europe.
  • Numerous factors contribute to RH, including medications, obesity, diabetes, renal disease, and endocrine disorders.

Purpose of the Study:

  • To summarize the definition, prevalence, contributing factors, diagnostic approaches, and treatment strategies for resistant hypertension.
  • To highlight the significance of identifying
  • non-dipper
  • hypertension and the role of circadian BP variations in treatment.

Main Methods:

  • Review of literature on resistant hypertension.
  • Emphasis on diagnostic evaluation including patient history, compliance assessment, physical examination, biochemical tests, and noninvasive imaging.
  • Inclusion of 24-hour ambulatory blood pressure monitoring (ABPM) for identifying non-dipper patterns.

Main Results:

  • Resistant hypertension affects a significant portion of hypertensive patients.
  • Various biological and lifestyle factors contribute to the condition.
  • Abnormal nocturnal BP patterns, particularly in chronic kidney disease patients, are clinically important.
  • Restoring normal nocturnal BP reduction is a significant predictor of reduced risk.

Conclusions:

  • Comprehensive diagnostic evaluation is crucial for managing resistant hypertension.
  • Addressing secondary causes and optimizing treatment, including chronotherapy based on circadian BP patterns, are essential.
  • Integrated non-pharmacological, pharmacological, and potentially invasive approaches are used for treatment.