Effects of Autogenic Training and Antihypertensive Agents on Circadian and Circaseptan Variation of Blood Pressure

Katinas

et al. 2003

J Circadian Rhythms

Self Cite

104

A few puzzles relating to a small fraction of my endeavors in the 1950s are summarized herein, with answers to a few questions of the Editor-in-Chief, to suggest that the rules of variability in time complement the rules of genetics as a biological variability in space. I advocate to replace truisms such as a relative constancy or homeostasis, that have served bioscience very well for very long. They were never intended, however, to lower a curtain of ignorance over everyday physiology. In raising these curtains, we unveil a range of dynamics, resolvable in the data collection and as-onegoes analysis by computers built into smaller and smaller devices, for a continued self-surveillance of the normal and for an individualized detection of the abnormal. The current medical art based on spotchecks interpreted by reference to a time-unqualified normal range can become a science of time series with tests relating to the individual in inferential statistical terms. This is already doable for the case of blood pressure, but eventually should become possible for many other variables interpreted today only based on the quicksand of clinical trials on groups. These ignore individual differences and hence the individual's needs. Chronomics (mapping time structures) with the major aim of quantifying normalcy by dynamic reference values for detecting earliest risk elevation, also yields the dividend of allowing molecular biology to focus on the normal as well as on the grossly abnormal.

Section: Introductionsupporting

confidence: 63%

“…From a clinical viewpoint, he started to meet the greatest challenge today: stroke prevention by 24-h/7-day blood pressure and heart rate monitoring for detection of changes in variability [8,38,77-80] and their treatment, Fig. 17[38,80-82]. He has now also started a similar city-wide project in a second location.…”

Section: Introductionmentioning

confidence: 99%

Transdisciplinary unifying implications of circadian findings in the 1950s

Halberg

Katinas

et al. 2003

J Circadian Rhythms

Self Cite

104

“…Dr. Yoshihiko Watanabe is a champion of systematic, rather than interrupted, automatic measurements: he has reported on his half-hourly values now covering 18 years [30][31][32][33][34][35][36][37][38][39][40][41][42][43], demonstrating, as did FH by superposed epochs [44], an association of his blood pressure with magnetic storms by cross-spectral coherences [32]. The overall champion of blood pressure measurements is undoubtedly Dr. Robert B. Sothern, whose data, about five times per day for 38 years, are also available in the literature, demonstrating the time course of blood pressure in clinical health [45][46][47].…”

Section: Introductionmentioning

confidence: 99%

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

Katinas

Biomedicine & Pharmacotherapy

Otsuka

et al. 2005

Several opinion leaders have monitored their blood pressure systematically a sufficient number of times a day for chronomic (time structural) analyses, from the time of encountering chronobiology until their death; they set an example for others who also may not wish to base treatment on single spotchecks in a health care office. Such self-measurements, while extremely helpful, were not readily feasible without a noteworthy interruption of activities during waking as well as of sleep. New, relatively unobtrusive instrumentation now makes monitoring possible and cost-effective and will save lives. Illustrative results and problems encountered in an as-one-goes self-survey by GSK, a physician-scientist, are presented herein. Both MESOR-hypertension and CHAT (circadian hyperamplitude-tension) can be intermittent conditions even under treatment, and treatment is best adjusted based on monitoring, rather than "flying blind".

“…This is particularly true since CHAT can be treated. In the absence of MESOR-hypertension, non-pharmacologic treatment with relaxation techniques such as autogenic training may be indicated [ 18,19]. In the presence of MESOR-hypertension, pharmacologic treatment may be optimized by timing antihypertensive drugs in relation to the chronodiagnosis (chronotheranostics), that is with a consideration of the variability in BP and HR.…”

Section: Discussionmentioning

confidence: 99%

“…In the presence of MESOR-hypertension, pharmacologic treatment may be optimized by timing antihypertensive drugs in relation to the chronodiagnosis (chronotheranostics), that is with a consideration of the variability in BP and HR. Some, but not all anti-hypertensive drugs lower an excessive circadian BP variation [19,20]. Scheduling the same dose of the same antihypertensive medication at different circadian stages may affect the circadian amplitude of BP differently, as assessed by parameter tests and a self-starting cumulative sum (CUSUM) control chart [3,11].…”

Section: Discussionmentioning

confidence: 99%

Opportunity of detecting pre-hypertension: worldwide data on blood pressure overswinging

Biomedicine & Pharmacotherapy

Delcourt

Toussaint

et al. 2005

Self Cite

Overswinging or CHAT (brief for Circadian Hyper-Amplitude-Tension), that is an excessive circadian variation in blood pressure (BP), has been associated with a large increase in cardiovascular disease risk, present even in the absence of an elevated BP itself. This usually asymptomatic condition is usually overlooked by current practice based on spot-checks, because to be diagnosed, measurements need to be taken around-the-clock, preferably for 7 days at the outset. Once diagnosed, however, a usual circadian BP pattern can be restored by means of certain non-pharmacologic or pharmacologic interventions timed appropriately. Thereby, it is possible to reduce the risk of cardiovascular morbidity and mortality, cerebral ischemic events and nephropathy in particular. For the preparation of guidelines regarding the diagnosis of BP disorders and for the institution of primary as well as secondary preventive measures, it is important to know what the incidence of CHAT is on a global basis. We found 191 cases of CHAT among 1602 mostly 7-day/24-h BP profiles, obtained from several centers in different countries participating in an ongoing project on the BIOsphere and the COSmos (BIOCOS). CHAT incidence is about the same between men and women, but it is diagnosed more often among patients with borderline hypertension or with glucose intolerance. It is also more common among MESOR-hypertensive than among MESOR-normotensive individuals.*Corresponding author. E-mail address: corne001 @umn.edu (G. Comdlissen). Priority should be given to the development of an unobtrusive and affordable device to automatically monitor BP and to analyze the data as-one-goes, so that cardiovascular disease risk can be prevented. NIH Public Access