In general the concept of homeostasis has been the base for treatment of diseases. Little importance has been given in understanding biologic rhythms and their underlying mechanisms. In general most of the cardiovascular drugs are designed to accomplish a constant or near-constant effect throughout the 24-hour dosing interval. However in many cases, the requirement for medication is not the same at nighttime as it is during the day. Body rhythms may have profound effect on treatment outcomes. Medical chronobiology deals with the mechanisms of body rhythm’s influences on health and diseases. Chronotherapeutics is the purposeful alteration of drug concentration to match rhythms to optimize therapeutic \outcomes and minimize size effects. It is wrongful approach to assume that a drug dosed in the morning will have the same antihypertensive effect as a drug dosed in the evening. The well documented circadian variations in blood pressure (BP), heart rate, hormone secretion, and platelet aggregation are examples of the impact of chronobiology. Based on this information, does treatment of hypertension worth a therapeutic paradigm shift? In this study we analyze the effect of circadian pattern of blood pressure on action of various antihypertensives and investigate the perspective of chronotherapeutics- whether it’s a fruitful approach and rationalize its utility in treatment of hypertension.
Keywords: Chronotherapeutics, hypertension, biologic rhythms, antihypertensives
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