Differential effects of antihypertensive drugs on circadian rhythm in blood pressure from the chronobiological point of view.
REVIEW IN DEPTH: The cardiovascular system is well organized in time. The blood pressure normally displays a circadian rhythm characterized by a nightly drop which, however, can be disturbed by disease. The 24 h blood pressure and its mechanisms of regulation are very dynamic and rhythmic processes. Ambulatory blood pressure monitoring data should, therefore, be analysed by more subtle methods than linear or cosinor analysis. The blood pressure lowering effects and the dose-reponse relationship of antihypertensive drugs can also be circadian phase-dependent. Antihypertensive drug treatment should not only aim to lower blood pressure but also to achieve a normal 24 h blood pressure pattern. Finally, when evaluating the duration of action it is mendatory to register the blood pressure by ambulatory monitoring for more than 24 h.
Lemmer
B
Institute of Pharmacology and Toxicology, Faculty of Clinical Medicine, Ruprecht-Karls-Universität, Heidelberg, Germany.