Blog entry by Meguid El Nahas
the MAPEC spanish propsective study of ~5,000 individual showed that sleep-time hypertension rather than casual-clinic BP or 24h ABPM was the independent risk factor for incident CKD.
Previous studies highlighted the prognostic relevance of sleep time systolic BP to the development of CVD; Consistent evidence of numerous studies substantiates the asleep blood pressure (BP) mean derived from ambulatory BP monitoring (ABPM) is both an independent and a stronger predictor of cardiovascular disease (CVD) risk than are daytime clinic BP measurements or the ABPM-determined awake or 24-hour BP means.
More attention needs therefore to be paid timely and adequate measure of BP in the population at a whole but also those at risk of CVD and CKD; the older population.
Consequently, more attention needs to be paid to the timely, evening, administration of anti-hypertensive medication. Chronotherapy improves hypertension management and its complications.
Nephrologists and general practitioners need to shift their management paradigm to a focus on bedtime, sleep BP monitoring as well as evening, bedtime, ingestion of the full daily dose of at least one antihypertensive agent.