[Diurnal changes in blood pressure and their consequences].

Author analyses the daily blood pressure and heart rate alterations due to circadian rhythm and their effects to development of dangerous clinical situations (sudden death, stroke, myocardial infarct, ischaemic episodes) in hypertension with or without ischemic heart disease. The most dangerous time-period is the morning hours, but serious problems are the sudden increases in blood pressure in any time of day as well. The daily changes in blood pressure (rise in blood pressure variability) are often associated with the alteration in heart rate (decrease in heart rate variability) and loss of dipp at night. The main cause of this "death-three" is the overactivity of the sympathetic nervous system. An antihypertensive drug with good quality can be capable to depress the high blood pressure continuously during the whole day inhibiting the rapid rise periods of blood pressure. The best measure of this effect is the high through/peak ratio.