Circadian Hyper-Amplitude-Tension (CHAT): A Disease Risk Syndrome of Anti-Aging Medicine

Abstract

Editor's Note: Talking about "blood pressure" as a single figure is similar to knowing the average height of a mountain range: an interesting statistic, but completely useless to a pilot trying to make it through a mountain pass alive. Realistically, we need to consider not merely the mean stress on an aging vascular endothelial cell, but the "peaks" that it has to "fly over" as well. Aging vessels are-to an extent-the end result of such stresses. Halberg et al. suggest that many patients may be apparently normotensive, yet (because of circadian peaks in blood pressure) have the catastrophic risks of any other severely hypertensive patient. They recommend that we avoid "flying blind" and begin to measure peak pressures more accurately if we are to avoid disaster. ABSTRACT Serial measurements, taken around the clock in the laboratory and clinic, can be analyzed by computer-implemented curve-fitting to assess the approximate 24-hour (circadian) variation, among other rhythmic and chaotic components of the time structure (chronome) of any vari¬ able. This approach is particularly important to quantify blood pressure variability, which renders even the most accurate single measurement into a snapshot on a roller coaster. A seemingly acceptable blood pressure can be particularly misleading when accompanied by the recommendation of another check-up in 2 years, which is the official position of the World Health Organization. An overswinging of the blood pressure along the 24-hour scale may then be missed. This excessive circadian amplitude, called "circadian hyper-amplitude-ten¬ sion" (CHAT), constitutes a new disease risk syndrome, warranting screening, diagnosis, and treatment. With or without the midline-estimating statistic of rhythm (MESOR) (i.e., the [chronome-adjusted] mean value), the circadian double amplitude, a measure of the extent of

Why continued surveillance? Intermittent blood pressure and heart rate abnormality under treatment

“…All figures of this publication reveal, for this case, more completely than was done earlier in others [55][56][57][58], that MESOR-hypertension under closely surveyed conditions can be a greatly changing phenomenon, as is CHAT [59]. Fig.…”

The brain decade in debate: IV. Chronobiology

“…Two new disease risk syndromes associated with large increases in vascular disease risk are circadian hyper-amplitude-tension (CHAT), a condition characterized by an excessive circadian amplitude of blood pressure, and chronome (time structure) alterations in heart rate variability. Increases in risk related to these disease risk syndromes are larger than any of the other risk factors tested by us so far on the same data sets, including old age and an elevation of blood pressure itself (hypertension) (15,16). The availability of noninvasive ambulatory monitors to measure automatically blood pressure, heart rate and R-R intervals around the clock for spans of one week or longer facilitates the collection of data for a refined diagnosis and also for a more rigorous assessment of responses to timed interventions.…”

Blood Pressure Variability Assessed by Semiautomatic and Ambulatorily Functional Devices for Home Use

“…Whereas the influence of external factors on BP and HR, whether from the habitat niche or from the interplanetary field [ll-14, 16, 171 and perhaps from beyond [ l l , 29, 301, can be paramount, as apparent from fleeting CHAT [26], an endogenous component is often overlooked. While the use of home (self') and ambulatory BP monitoring has dramatically increased over the past few years, guidelines for its recommendation are mostly based on the fact that it provides a more accurate estimate of the mean value, thus being useful for diagnostic purposes [21].…”