THE EFFECTIVENESS OF CHRONOTHERAPY IN HYPERTENSIVE PATIENTS WITH AN INSUFFICIENT DEGREE OF SLEEP-TIME DIASTOLIC BLOOD PRESSURE

Abstract

The violation of daily blood pressure (BP) profile is one of the predictors of cardiovascular (CV) morbidity and mortality in patients with arterial hypertension (AH). It is determined by ambulatory BP monitoring (ABPM). The aim of the study was to assess the impact of the chronotherapeutic approach on the level of systolic blood pressure (SBP) and diastolic blood pressure (DPB) and daily BP profile in patients with AH with insufficient degree of sleep-time relative DBP decline.  The study included 28 patients with AH with nondipper DBP daily profile in age from 52 to 78 years old. The participants were divided onto two groups. Group 1 included 14 patients, who take all antihypertensive drugs in the morning, group 2 included 14 patients who takе at least one antihypertensive drug at bedtime. All patients underwent 24-hour blood pressure monitoring using the computer system «Cardiosens» (KhAI Medica, Ukraine, with the oscillometric method of BP measurement) when enrolling in the study and after 3 months. The type of SBP and DBP diurnal profile, the mean values of SBP, DBP and hyperbaric indices were determined and compared between groups 1 and 2 at each visit, as well as within groups between visits. The results showed that morning taking of antihypertensive drugs in patients with AH with insufficient degree of DBP decline influences more on SBP while evening taking – on DBP. It was concluded that violation of DBP daily profile in medication therapy of patients with insufficient degree of DBP decline should be provided along with violation of SBP daily profile.