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

Katinas, George; Cornélissen, Germaine; Otsuka, Kuniaki; Haus, Erhard; Bakken, Earl E.; Halberg, Franz

doi:10.1016/s0753-3322(05)80022-8

Cited by 5 publications

(3 citation statements)

References 14 publications

(12 reference statements)

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“…After completion of intensive therapy 12-hour component was again lost, and the leading position returned to 24-hour one. Inhibition of 24-sc in the rhythm of blood pressure with the replacement of them by 12-sc has been noted also previously in the same person after a sudden increase in the dosage of antihypertensive drugs [6]. …”

Section: Discussionsupporting

confidence: 58%

Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

Чибисов

Katinas

Brodskaya

et al. 2013

Cardiology Research and Practice

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Dynamics of blood pressure (BP) and heart rate (HR) was traced by automatic monitoring every 30 min uninterruptedly along several months in a patient suffering from combined atrial fibrillation and heart failure during the development of disease and its therapeutic and surgical treatment (pacemaker implanting and atrioventricular ablation). Analyses of spectral components as well as signal's shape revealed instabilities in circadian and semicircadian parameters. A new approach for signal's form description without using cosine approximation is suggested. The meaning that referring a patient as dipper, night peaker, or nondipper might be useful at choosing tactics of his treatment is impugned, because all these “types” can transform themselves in the same person in few days. Optimization timing of treatment provides better results if not the “types” of daily profile would be taken to account but the real form of the BP-signal and timing its first and second derivatives.

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Section: Discussionsupporting

confidence: 58%

Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

Чибисов

Katinas

Brodskaya

et al. 2013

Cardiology Research and Practice

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“…(3) Hyperbaric and tachycardic indices, representing the area under the curve delineated by the subjectstacked profile when it was excessive (above) and over (upper) the chronodesmic limit. [20][21][22][23] Day-night ratios were also computed for the record as a whole and for each day separately, for a classification in terms of 'dipping'. A negative daynight ratio was classified as 'reverse dipping'.…”

Section: Discussionmentioning

confidence: 99%

Prediabetes is associated with abnormal circadian blood pressure variability

et al. 2008

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Blood pressure (BP) exhibits a circadian variation characterized by a morning increase, followed by a small postprandial valley and a deeper descent during nocturnal rest. Although abnormal 24-h variability (abnormal circadian variability (ACV)) predicts adverse cardiovascular disease (CVD) outcomes, a 7-day automatic ambulatory BP monitoring (ABPM) and subsequent chronobiologic analysis of the gathered data, permits identification of consistency of any abnormal circadian variation. To test whether normal overweight healthy men and women with prediabetes differed from subjects with normoglycemia in having ACV with a 7-day ABPM. Consent for a 7-day ABPM was obtained from subjects with family history of diabetes mellitus, who were participating in the screening phase for a randomized, double blind, placebo-controlled weight loss trial in prediabetics to prevent progression to diabetes mellitus. The automatic 7-day ABPM device recorded BP and heart rate every 30 min during the day and every 60 min during the night. Normoglycemic and prediabetic subjects matched for age, sex, race, BP, BMI, waist circumference and glycemic control, differed statistically significantly only in their fasting and/or 2-h postprandial serum glucose concentrations. Chronobiologically-interpreted 7-day ABPM uncovered no abnormalities in normoglycemics, whereas prediabetics had a statistically significantly higher incidence of high mean BP (MESOR-hypertension), excessive pulse pressure and/or circadian hyper-amplitude-tension (CHAT) (Po0.001). ACV detected with 7-day ABPM may account for the enhanced CVD risk in prediabetes. These findings provide a basis for larger-scale studies to assess the predictive value of 7-day ABPM over the long term.

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“…on different Rx. Rx at start: Diltiazem 90 mg at ~ 06:00, 15:00, many adjustments of Rx during 7 years (Katinas et al 2005bI).…”

Section: Fig2bmentioning

confidence: 99%

Chronobiology's progress. Part I, season's appreciations 2004-2005: time-, frequency-, phase-, variable-, individual-, age- and site-specific chronomics

Halberg

Cornélissen²,

Katinas³

et al. 2006

JAB

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New components of transdisciplinary spectra or known components in new variables in us, matching those around us, are being mapped. Their hardly trivial interactions associated with the good and bad around us -from religiosity to crime and war -are being rendered measurable, for the eventual development of countermeasures to the diseases of societies and nations. Internal cycles not only underlie life itself and underlie our evolving genetics at all levels of organization; they also constitute the essential control and reference information in all transdisciplinary science. In preparing for travel to Mars and other missions in space that may take more than a year, let us do what is immediately practicable. Transyears may have very small amplitudes yet are associated with sudden cardiac death in some terrestrial locations; if they should play a role in these electrical incidents of the heart, among others like myocardial infarction and stroke, they will jeopardize lengthy missions in extraterrestrial space, away from hospitals.The likelihood of stroke or cardiac death can be immediately reduced by chronobiologically assessing blood pressure and heart rate variability and by optimizing the efficacy of timed treatment rather than relying on an unacceptable and often inaccurate spotcheck and treating by convenience rather than pertinence. Needed are: detection of nocturnal abnormality when medication may no longer be effective (or is too effective) neither seen during office visits by day; detection of circadian hyperamplitude-tension (CHAT) associated with a risk of stroke and kidney disease greater than other risks Halberg et al.: Chronobiology's progress I 2 (including "hypertension" when all risks are assessed concomitantly); detection of CHAT as high risk among normotensives who may not need anti-hypertensive medication; individualized inferential statistical testing to determine whether a drug or non-drug intervention such as autogenic training (relaxation) is effective and for how long (detecting any initial and later success or failure), some of which conditions otherwise are not found without chronobiology; individualization of treatment timing, since the same dose of the same medication can further lower the subject's blood pressure average and circadian amplitude when the timing of daily administration is optimized, as ascertained by sequential testing and parameter tests.Thus, we save lives by monitoring and assessing, and if need be treating, vascular disease risk through chronobiologically interpreted 24-hour or preferably longer (24-hour/7-day) blood pressure and heart rate variability. Abnormalities in the variability of blood pressure and heart rate, impossible to find during a conventional office visit (the latter aiming at the fiction of a "true" blood pressure), can raise cardiovascular disease risk in the next six years from 4% to 100%.· Dedicated to Alejandro Zaffaroni, who came as a pleasant surprise with flowers and more. May a marker-guided preventive chronotherapy of elevations of the risks ...

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

Cited by 5 publications

References 14 publications

Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatment

Prediabetes is associated with abnormal circadian blood pressure variability

Chronobiology's progress. Part I, season's appreciations 2004-2005: time-, frequency-, phase-, variable-, individual-, age- and site-specific chronomics

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