晨起血压激增：治疗意义
The morning blood pressure surge: therapeutic implications.
作者信息
Patel Priyesh V, Wong Justin L, Arora Rohit
机构信息
Department of Cardiology, Chicago Medical School at the Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
出版信息
J Clin Hypertens (Greenwich). 2008 Feb;10(2):140-5. doi: 10.1111/j.1751-7176.2008.07427.x.
Abstract
Adverse cardiovascular events such as myocardial infarction, stroke, arrhythmias, and sudden cardiac death are well known to follow a circadian pattern, peaking in the morning hours of 6 AM to 12 PM. Many physiologic factors have been shown to follow a circadian pattern and together may create an environment that promotes intraluminal thrombi formation. Blood pressure follows this pattern with a "dip" at night and an increase on awakening. This morning surge may lead to hemodynamic forces that predispose patients to plaque rupture. The clinical impression of these known physiologic patterns associated with adverse cardiovascular events suggests that a strict treatment schedule targeting this phenomenon is needed. The goal of this review is to provide clinicians with an overview, allowing for informed decisions about chronotherapeutic formulations tailored to provide blood pressure control throughout the day and night.
摘要
众所周知，心肌梗死、中风、心律失常和心源性猝死等不良心血管事件呈现昼夜节律模式，在上午6点至12点达到峰值。许多生理因素已被证明呈现昼夜节律模式，它们共同作用可能会营造出促进管腔内血栓形成的环境。血压也遵循这种模式，夜间会出现“低谷”，醒来时升高。这种早晨血压的激增可能会导致血流动力学变化，使患者易发生斑块破裂。这些与不良心血管事件相关的已知生理模式的临床情况表明，需要制定针对这一现象的严格治疗方案。本综述的目的是为临床医生提供一个概述，以便他们能够做出明智的决策，选择适合昼夜血压控制的时辰治疗制剂。
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