Yagi Shusuke, Sata Masataka
Nihon Rinsho. 2014 Aug;72(8):1466-71.
Circadian rhythm of blood pressure (BP) has recently been focused on because increase in nocturnal BP and morning BP surge have been shown to be risks for cardio-cerebrovascular diseases independent of 24-h BP level. The renin-angiotensin-aldosterone system (RAAS) is involved in BP circadian rhythm, and RAAS inhibitors therefore play an important role in the control of circadian rhythm of BP. Bedtime administration of RAAS inhibitors is more effective than morning administration for reducing nocturnal and morning BP levels in addition to converting the BP profile into a dipper pattern, which is known as chronotherapy. For reducing cardio-cerebro-vascular events, controlling abnormal circadian rhythm of BP in addition to 24-h BP using RAAS inhibitors with optimal time dosing should be considered.
血压的昼夜节律最近受到关注，因为夜间血压升高和清晨血压激增已被证明是心脑血管疾病的危险因素，独立于24小时血压水平。肾素-血管紧张素-醛固酮系统（RAAS）参与血压昼夜节律，因此RAAS抑制剂在控制血压昼夜节律中发挥重要作用。睡前服用RAAS抑制剂比早晨服用更有效地降低夜间和清晨血压水平，此外还能将血压模式转变为勺型模式，这被称为时间疗法。为了减少心脑血管事件，除了使用24小时血压外，还应考虑使用最佳时间给药的RAAS抑制剂来控制异常的血压昼夜节律。
