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Essential Manual of 24 Hour Blood Pressure Management. From Morning to Nocturnal Hypertension. Edition No. 1

  • ID: 3110405
  • Book
  • May 2015
  • 150 Pages
  • John Wiley and Sons Ltd
It is well known that cardiovascular events occur more frequently in the morning as blood pressure (BP) levels have been shown to increase during the period from night to early morning. In recent years, clinical research using ambulatory blood pressure monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than clinical BP. This practical manual from field leading expert, Dr. Kazuomi Kario, reviews recent evidence on Âmorning and Ânocturnal hypertension and the IT technologies physicians can use to support patients in home monitoring BP. Guidance on management via antihypertensive drugs is also discussed and with the aim of promoting Âperfect 24 hour BP controlÂ.
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Author biography viii

Preface x

Acknowledgments xi

1 First focusing on “morning hypertension” 1

What is the “perfect 24-hour blood pressure control”? 1

Definition of “morning hypertension” 4

How to assess “morning hypertension” 5

Home BP monitoring 7

Ambulatory BP Monitoring 9

Feasibility of controlling morning hypertension 12

Subtypes of morning hypertension 14

2 Morning surge in blood pressure 15

Definition of MBPS 15

Cardiovascular events with MBPS 16

Organ damage with MBPS 19

Hypertensive heart disease 20

Vascular disease and inflammation 21

Silent cerebrovascular disease 22

Chronic kidney disease 24

Determinants of MBPS 25

Mechanism of morning risk 28

Hemostatic abnormality and MBPS 29

Vascular mechanism of exaggerated MBPS 31

3 Nocturnal hypertension 35

Circadian rhythm of BP 35

Non-dipper/risers of nocturnal BP 35

Definition and risk of nocturnal hypertension 38

Mechanism of nocturnal hypertension 43

Associated conditions 44

Diabetes 45

Chronic kidney disease 47

Sleep apnea syndrome 48

Extreme dipper - another type of disrupted circadian BP rhythm 48

4 What is systemic hemodynamic atherothrombotic syndrome? 50

A typical case of SHATS 50

Clinical relevance of SHATS 52

Pathological target of SHATS 54

Mechanism of vicious cycle of SHATS 57

5 Home blood pressure variability 61

Maximum home SBP 61

SD of morning SBP 62

Morning orthostatic hypertension 64

6 Development of information technology-based new home blood pressure variability monitoring system 67

Disaster cardiovascular prevention network 67

Cutting-edge of HBPM 71

Basic nocturnal BP monitoring at home (Medinote) 71

“Thermosensitive hypertension” detecting home BP device 74

Trigger nocturnal BP monitoring 75

IT-based trigger nocturnal pressure monitoring system 81

Detection and management of OSAS using new IHOPE-TNP 82

7 Home blood-pressure-monitoring guided morning hypertension control 88

Non-specific treatment 88

Specific treatment 89

8 Blood-pressure-lowering characteristics of antihypertensive drugs 91

Diuretics 91

Calcium channel blockers 91

Amlodipine 92

Nifedipine 94

Cilnidipine 95

Azelnidipine 96

Angiotensin-converting enzyme inhibitors 96

Angiotensin-receptor blockers 98

Telmisartan 98

Candesartan 98

Olmesartan 99

Azilsartan 103

Alpha-adrenergic blockers and beta-adrenergic blockers 104

RAS inhibitor-based combination 106

9 Home and ambulatory blood-pressure-profile-based combination strategy 109

First-line therapy 109

Second-line therapy 109

Arterial stiffness type 109

Volume retention type 110

Third-line therapy 110

10 Management of resistant hypertension 111

Evaluation of resistant hypertension 111

Fourth-line therapy 111

Circadian medication 114

11 Era of renal denervation 115

Evidence of renal denervation 115

Hypothesis of “perfect 24-hour BP control” by renal denervation 116

12 Latest evidence of controlling morning hypertension: the HONEST study 118

Conclusion and perspectives 122

References 123

Index 135

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Kazuomi Kario University College London, London, UK.
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