The morning blood pressure surge: therapeutic implications.
Adverse cardiovascular events such as myocardial infarction, stroke, arrhythmias, and sudden cardiac death are well known to follow a circadian pattern, peaking in the morning hours of 6 AM to 12 PM. Many physiologic factors have been shown to follow a circadian pattern and together may create an environment that promotes intraluminal thrombi formation. Blood pressure follows this pattern with a "dip" at night and an increase on awakening. This morning surge may lead to hemodynamic forces that predispose patients to plaque rupture. The clinical impression of these known physiologic patterns associated with adverse cardiovascular events suggests that a strict treatment schedule targeting this phenomenon is needed. The goal of this review is to provide clinicians with an overview, allowing for informed decisions about chronotherapeutic formulations tailored to provide blood pressure control throughout the day and night.
Patel
Priyesh V
PV
Department of Cardiology, Chicago Medical School at the Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
Wong
Justin L
JL
Arora
Rohit
R
D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D019454:Chronotherapy; D002940:Circadian Rhythm / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
D000959:Antihypertensive Agents