scholarly journals Effect of antihypertensive drugs on circadian variation of blood pressure measured by ambulatory blood pressure monitoring in controlled hypertensive individuals

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
RohitJacob Manoj ◽  
Anand Nikalje
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Circadian Variation ◽  
Pressure Monitoring

Applications of ambulatory blood pressure monitoring in clinical practice

1991 ◽  
Vol 37 (10) ◽  
pp. 1880-1884 ◽  
Author(s):  
M A Weber ◽  
D H Smith ◽  
J M Neutel ◽  
D G Cheung
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Ambulatory Monitoring ◽  
White Coat Hypertension ◽  
Portable Devices ◽  
Pressure Monitoring

Abstract Traditionally, blood pressure has been measured by the sphygmomanometer in the medical office. There is growing evidence, however, that office blood pressures may not be typical of values throughout the day. Between 20% and 30% of patients diagnosed with hypertension in the office actually are normotensive at other times. Ambulatory blood pressure monitoring with small, portable devices that automatically measure blood pressure every few minutes throughout the day appears to be an appropriate tool when "white-coat" hypertension is suspected--i.e., for individuals whose hypertension in the physician's office is not associated with other physical or historical evidence for cardiovascular disease or with other risk factors. Used prudently, ambulatory monitoring is a cost-effective technique that potentially can prevent unnecessary treatment of patients. Moreover, whole-day measurements may correlate more closely than office measurements may correlate more closely than office measurements do with findings of cardiovascular disease. This new approach also has highlighted the circadian pattern of blood pressure, especially the sharp early to mid-morning increase that coincides with an increased tendency to major cardiovascular events. This has focused attention on directing antihypertensive therapy towards the morning hours. Ambulatory monitoring is now used routinely in studies of antihypertensive drugs. This technique has no placebo effect and takes fewer patients to assess drug efficacy than do conventional methods.

Methodology to Determine Duration of Action for Antihypertensive Drugs

2002 ◽  
Vol 36 (5) ◽  
pp. 874-881 ◽  
Author(s):  
Jean Lefebvre ◽  
Luc Poirier ◽  
Yves Lacourcière
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Antihypertensive Agents ◽  
Pressure Monitoring ◽  
Duration Of Action ◽  
Short Acting ◽  
Acting Agent

OBJECTIVE: To review and comment on methods used to assess the duration of action of antihypertensive drugs. DATA SOURCES: A MEDLINE search (1966–June 2000) using key terms such as trough-to-peak ratio and ambulatory blood pressure monitoring was conducted. STUDY SELECTION: An article was considered for this review if it pertained to the assessment of the duration of action of antihypertensive drugs. Special attention was given to articles dealing with methodologic aspects. DATA SYNTHESIS: Antihypertensive drugs with a long duration of action are thought to provide better therapeutic coverage against hypertensive complications compared with that of short-acting agents. Measuring blood pressure at the end of the dosing interval may be a way to assess the duration of action of a drug. However, the use of high doses of a short-acting agent to obtain sufficient effect when at trough concentrations can potentially cause dose-related adverse effects at the peak time, contributing to nonadherence to therapy and thus to adverse outcomes. To alleviate this problem, the US Food and Drug Administration (FDA) has conceptualized the trough-to-peak (T:P) ratio. Although this arithmetic index has since been widely used to characterize the duration and safety of blood pressure control achieved by antihypertensive agents, several methodologic flaws limit its interpretation in the clinic. Ambulatory blood pressure monitoring (ABPM) is a more reliable approach to assess the duration of action and outcome of antihypertensive therapy. CONCLUSIONS: Different methodologic approaches exist to evaluate the duration of action of antihypertensive drugs. Although the T:P ratio has been suggested by the FDA, it is difficult to establish a fair comparison among various antihypertensive agents based solely on this index. Treatment evaluation based on ABPM may be preferable to those guided by T:P because ABPM is more reproducible and is now established as a predictor of cardiovascular risk.

Ambulatory Blood Pressure Monitoring: Measurement Implications for Research

2001 ◽  
Vol 9 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Carolyn B. Yucha
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Computer Software ◽  
Research Assistant ◽  
Pressure Monitoring ◽  
Ambulatory Bp Monitoring ◽  
The Cost

Although blood pressure (BP) is a frequently used variable in nursing studies, measurements are likely to be inaccurate for a variety of reasons: incorrect technique, operator error, and environmental factors. Ambulatory BP monitoring (ABPM) reduces measurement error, is relatively easy to use, and yields many more BP parameters than do clinic BP measurements. The cost of equipment for ABPM ranges from $2,500 to $5,000 per monitor and from $2,000 to $3,000 for computer software. A research assistant can easily be trained to follow a standardized procedure. Researchers have used ABPM to study normal BP patterns, complications of hypertension, effects of antihypertensive drugs, and the prognosis of cardiovascular events. This article provides the nurse researcher with an introduction to this technology and an overview of information gained from ambulatory blood pressure monitoring.

scholarly journals Nocturnal hypertension in acute heart failure patients: 24 hours blood pressure pattern

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
AM Gonzalez Gonzalez ◽  
AM Garcia-Bellon ◽  
M Cano-Garcia ◽  
R Vivancos-Delgado
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Acute Heart Failure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Circadian Variation ◽  
Pressure Monitoring ◽  
Nocturnal Hypertension ◽  
Heart Failure Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background It is well defined the prognosis value of the abnormalities in the circadian variation in hypertensive patients. In the phisiopathology of heart failure, neurohumoral mechanism plays an important role. Nevertheless, the circadian variation in nonhypertensive heart failure patients has not been well evaluated. Purpose Our aim was to evaluate 24-h blood pressure patterns and the prevalence of nocturnal hypertension in patients admitted with acute heart failure. Methods We studied 122 patients with a clinical diagnosis of AHF. We permormed a 24-h  ambulatory blood pressure monitoring as well as an echocardiogram and anaytical test. Results 122 patients. Mean age: 63 ± 10. Males: 75%. Mean BMI: 30 ± 6 Kg/m2. Associated risk factors: 56,6% hypertension, 40 % dyslipidemia, 34,7% Diabetes, 29,3% obesity, 22,9% smoking. The etiology of HF: ischemic 41,2%;hypertensive 22,7%; dilated cardiomyopathy 20,9%;valvular 8,3%; others 6,9%.Therapeutic regimen applied: RAS blockers 93,4%; betablockers 85,7%; loop diuretic 81%; spironolactone 42,3%; statins 68,4%; antiplatelet/anticoagulant drugs 89%. The 24 h ABPM measurements are in table 1 The majority of AHF patients (80,4%) have an abnormal pattern of ABPM: Dipper 19,6%, non-dipper 51,1%, riser 0%.The prevalence of nocturnal hypertension was 22,8%. Conclusions In our area, AHF patients have optimal control of BP , however, the normal circadian variation in blood pressure is altered in most of them. In addition, nocturnal hypertension is very common in heart failure patients. Ambulatory blood pressure monitoring may be helpful in identified this altered patterns (which could be unrecognized) and may be used to optimise heart failure therapy,  and could be a prognosis marker in this patient group. Table 124 hoursDaytimeNightimeSysolic BP107,7 ± 13,8109,6 ± 14,2104,5 ± 14,5Diastolic BP64,4 ± 7,866,4 ± 8,860,4 ± 7,6

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