Different Chronotherapy Protocols Applied to Blood Pressure
| Authors | |
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| Year of publication | 2017 |
| Type | Article in Proceedings |
| Conference | Noninvasive methods in cardiology 2017 |
| MU Faculty or unit | |
| Citation | |
| Web | https://is.muni.cz/do/med/noninvasive_methods_in_cardiology/noninvasive_methods_in_cardiology_2017.pdf |
| Description | Blood pressure serves both as a marker variable and as a gauge of the response to timed treatment (chronotherapy). The relative merits of several transverse and longitudinal chronotherapy designs are reviewed herein, from small studies on groups and N-of-6 pilot studies to larger clinical trials. Some chronotherapy designs are aimed at optimal results for the average patient in a given target population, while others aim at personalized chronotherapy, where each patient in the study is considered as an N-of-1 pilot. All chronotherapy trials considered herein relied on around-the-clock blood pressure measurements obtained automatically to determine optimal treatment times. Because anti-hypertensive medications can affect the circadian amplitude in addition to the rhythm-adjusted average (MESOR), treatment effects should be assessed on all characteristics of the circadian blood pressure rhythm. Because abnormal blood pressure and heart rate variability also relates to cardiovascular disease risk, anti-hypertensive treatment should target not only the lowering of blood pressure, but also the restoration of an acceptable circadian variation in blood pressure. Methods to analyze individual blood pressure records makes it now feasible to determine personalized optimal treatment times. Outcome studies remain to be performed to assess the gain to be obtained from personalized chronotherapy in terms of an actual decrease in adverse cardiovascular events. |