CHRONOTHERAPY IN RESISTANT HYPERTENSION: IMPROVEMENT OF RENAL FUNCTION BY INCREASING THE DAY/NIGHT BLOOD PRESSURE （BP） RATIO.
作者单位：Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain. Bioengineering ＆ Chronobiology Labs. Univ.Vigo Vigo Spain Hospital Clínico UniversitarioSantiagoSpain.
会议名称：《第十五届国际药理学大会》
会议日期：2006年
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
摘 要：正 We have prospective evaluated the potential beneficial effects of chronotherapy on renal function in patients with resistant hypertension. We studied 213 patients who were receiving 3 antihypertensive drugs in a single morning dose. Patients were randomly assigned to one of two groups according to the modification in their treatment strategy: 1) Changing one of the drugs,but keeping all 3 in the morning. 2) The same approach but administering the new drug at bedtime. BP was measured for 48h at baseline and after 3 months of intervention. The diurnal/nocturnal BP ratio was slightly reduced with all drugs on awakening,but significantly increased in patients receiving one drug at bedtime （P 0.001）. The percent decrease from baseline in urinary albumin excretion （ UAE） and increase in glomerular filtration rate （GFR） after treatment were significantly correlated with the increase in diurnal/nocturnal BP ratio （P 0.001）. Chronotherapy allows increasing the diurnal/nocturnal BP ratio towards a more dipper profile. This change in the circadian BP pattern is correlated with the improvement of renal function associated to reverting the high-risk non-dipper pattern into a dipper BP profile.