Publication details
Chronobiologically Interpreted Ambulatory Blood Pressure Monitoring in Health and Disease
| Authors | |
|---|---|
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Global Advances in Health and Medicine |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | Chronobiology; ambulatory blood pressure; hypertension;circadian; coherence; C-ABPM; stress; vascular variability anomaly; disorder; syndrome |
| Description | To detect vascular variability anomalies (WAs), a blood pressure and heart rate profile around the clock for at least 7 days is a start. As a minimum, measurement every 60 preferably 30 minutes for a week is needed, to be continued if abnormality is found, to assess the about 24-hour (circadian) variability that exists in all individuals. As a first dividend, one then also obtains a glimpse of 2 of the very many longer-than-circadian periodicities, the biological half-week and week. Certainly if we can have sensors and computer chips in our cars that continuously monitor the pressure over a life, we should be able to do the same job for ourselves for diagnostic and therapeutic decisions. Healthcare today emphasizes wellness with recommendations for exercise and a proper diet, yet these evaluations may not be adequate. BP maybe measured at a visit to the doctor or before an exercise session, along with measuring body weight and performing a physical exam. The seeds of disease are planted long before they are visible, and what appears to be normal from a conventional point of view may in fact be abnormal. Hidden alterations of physiological function, masked by the bodys remarkable adaptive capabilities, may become visible through a new diagnostic and therapeutic realm-chronobiology that reveals hitherto unseen abnormalities. The tools of chronobiology may yield additional dividends, such as the detection of physiological "loads" related to stress and stress relief and the undesirable effects of space weather upon personal events such as sudden cardiac death, societal events like terrorism and war, and natural disasters. Chronobiologically interpreted automatic ambulatory BP and heart rate (HR) monitoring (C-ABPM) may detect the antecedents of these types of events, C-ABPM is of interest in preventive cardiology, since it reveals new diagnoses as vascular variability anomalies (WAs) and renders previous conventional diagnoses more reliable, such as that of an elevated BE. These WAs include MESOR (midline-estimating statistic of rhythm)-hypertension, an elevation of the MESOR, which is diagnosed, like all other WAs, only after I or preferably several replications of 7-day around-the-clock BP monitoring with available, affordable, and unobtrusive instrumentation. The recommendation for continuous C-ABPM recognizes several principles that constitute inseparably intertwined contributors to severe cardio-, cerebro- and renovascular diesase, C-ABPM gauges wear and tear of genetics, physical loads, and in particular mental stress placed upon individuals from "womb to tomb" by daily life, including weather in extra-terrestrial spáce as well as that on earth, as a continuous surveillance paradigm preventing us from flying blind to a change from less than 5% to near 100% in the risk of a stroke within 6 years. |