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sleep & blood pressure
Physiology:
- in healthy people, blood pressure declines 15% in association with parasympathetic responses during sleep [2,3]
- an early morning blood pressure surge occurs, that begins before awakening
- a small post-prandial decline occurs & a more significant decline in blood pressure occurs during nocturnal sleep [1]
Pathology:
- attenuation of the decline in blood pressure during sleep is associated with increased amyloid burden in the posterior cingulate gyrus & altered cerebral blood flow of patients with mild cognitive impairment [2]
- persons without blood pressure decline with sleep are at increased risk for cardiovascular mortality, heart failure, & stroke [3]
- nighttime dosing of antihypertensives may be associated with decreases in cardiovascular events & death [3]
References
- Hermida RC
Ambulatory blood pressure monitoring in the prediction of
cardiovascular events and effects of chronotherapy: rationale
& design of the MAPEC study.
Chronobiol Int 2007, 23:749
PMID: 17701685
- Tarumi T et al.
Amyloid burden and sleep blood pressure in amnestic mild
cognitive impairment.
Neurology 2015 Dec 1; 85:1922
PMID: 26537049
- Labos C
Is Taking Blood Pressure Medications at Night Really Better?
Medscape - Feb 22, 2021.
https://www.medscape.com/viewarticle/945200
- Mathur P, Kadavath S, Marsh JD, Mehta JL
Chronotherapy for Hypertension: Improvement in Patient Outcomes With
Bedtime Administration of Antihypertensive Drugs.
Eur Heart J. 2020;41(48):4577-4579
PMID: 31723974
https://www.medscape.com/viewarticle/944367