IMPACT OF CHRONOTHERAPY ON HYPERTENSION MANGEMENT: INVESTIGATION PROTOCOL IN ATTEMPTING OF CLARIFICATION
DOI:
https://doi.org/10.58043/rphrc.34Abstract
Introduction: Arterial hypertension is an important risk factor for cardiovascular events, such as acute myocardial infarction or stroke. Chronotherapy consists in using daily (circadian) or monthly hormonal rhythms to treat diseases, enhance the effects of medications and minimize iatrogenesis. It is, however, a poorly explored area, although there is evidence that chronotherapy might be useful in the treatment of hypertension.
Primary objective: To evaluate the clinical interest of chronotherapy in the treatment of hypertension.
Type of study: Multicentric, observational, cross-sectional and analytical.
Research questions: Is the blood pressure pattern (dipper, non-dipper), assessed over 24 hours, conditioned by the time of administration of antihypertensive drugs (evening vs. morning)? Is blood pressure control conditioned by the time of administration of antihypertensive drugs (evening vs. morning)?
Methodology: The information will be collected from patient’s clinical computerized process, namely the hypertension pattern (dipper or non-dipper), obtained by ABPM.
Patients who do not have a characterization of their hypertension pattern by ABPM, will be asked to do so, in order to fulfill the conditions to integrate the study.
Patients will be divided into two study groups, each with 200 patients, that is, 400 patients in total. In group A there will be patients who follow a therapeutic plan with anti-hypertensive medication administered in the afternoon and in group B, there will be patients who follow a therapeutic plan with anti-hypertensive medication administered in the morning.
Results: It will be used a quantitative method. The p value defined for considering a statistically significant result will be p <0.05.
Conclusion: The circadian rhythm of blood pressure is particularly relevant in medicine; however, it remains a concept often ignored. Thus, it becomes necessary to raise awareness of its importance in clinical practice, in order to better understand the mechanisms of the disease, and to be able to provide more effective and advantageous forms of treatment for patients, being that the greatest purpose of this research protocol.
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