Importance Of Chronotherapy In Blood Hypertension

Abstract

Background: Blood pressure (BP) has a marked variation throughout the day. Recently the absence of a night-time drop in systolic blood pressure has demonstrated to increase cardiovascular morbidity and mortality beside other risk factors. In response chronotherapy has emerged as a strategy that has proven to reduce cardiovascular morbidity in hypertensive patients. Case Report: We report here a 72 year old female with Hypertension, Dyslipidemia and Obesity. The medical examination revealed, abdominal obesity, Body Mass Index 37 kg / m2, Office blood pressure 161/81 mmHg. Cardiopulmonary auscultation was normal. The rest of her physical examination was normal. A 24 hour Blood Pressure Monitoring (ABPM) was performed, it revealed higher BP during the night-time (Riser pattern). Because of the high cardiovascular risk, the with-coat effect and the riser status, we decided to perform cronotherapy. A follow up ABPM was performed 8 weeks later. It revealed changes in the circadian pattern and better control of Office blood pressure. Conclusion: The ultimate goal of antihypertensive treatment is to reduce cardiovascular morbidity and mortality, therefore the patient circadian pattern and pharmacokinetics of antihypertensive drugs should be consider when deciding antihypertensive therapy.