sleep & blood pressure
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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]
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]
References
- ↑ 1.0 1.1 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: https://www.ncbi.nlm.nih.gov/pubmed/17701685
- ↑ 2.0 2.1 2.2 Tarumi T et al. Amyloid burden and sleep blood pressure in amnestic mild cognitive impairment. Neurology 2015 Dec 1; 85:1922 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26537049
- ↑ 3.0 3.1 3.2 3.3 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: https://www.ncbi.nlm.nih.gov/pubmed/31723974 https://www.medscape.com/viewarticle/944367