Main description:

It is well known that cardiovascular events occur more frequently in the morning as blood pressure (BP) levels have been shown to increase during the period from night to early morning. In recent years, clinical research using ambulatory blood pressure monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than clinical BP. This practical manual from field leading expert, Dr. Kazuomi Kario, reviews recent evidence on "morning" and "nocturnal" hypertension and the IT technologies physicians can use to support patients in home monitoring BP. Guidance on management via antihypertensive drugs is also discussed and with the aim of promoting "perfect 24 hour BP control".

Contents:

Author biography viii Preface x Acknowledgments xi 1 First focusing on morning hypertension 1 What is the perfect 24-hour blood pressure control ? 1 Definition of morning hypertension 4 How to assess morning hypertension 5 Home BP monitoring 7 Ambulatory BP Monitoring 9 Feasibility of controlling morning hypertension 12 Subtypes of morning hypertension 14 2 Morning surge in blood pressure 15 Definition of MBPS 15 Cardiovascular events with MBPS 16 Organ damage with MBPS 19 Hypertensive heart disease 20 Vascular disease and inflammation 21 Silent cerebrovascular disease 22 Chronic kidney disease 24 Determinants of MBPS 25 Mechanism of morning risk 28 Hemostatic abnormality and MBPS 29 Vascular mechanism of exaggerated MBPS 31 3 Nocturnal hypertension 35 Circadian rhythm of BP 35 Non-dipper/risers of nocturnal BP 35 Definition and risk of nocturnal hypertension 38 Mechanism of nocturnal hypertension 43 Associated conditions 44 Diabetes 45 Chronic kidney disease 47 Sleep apnea syndrome 48 Extreme dipper another type of disrupted circadian BP rhythm 48 4 What is systemic hemodynamic atherothrombotic syndrome? 50 A typical case of SHATS 50 Clinical relevance of SHATS 52 Pathological target of SHATS 54 Mechanism of vicious cycle of SHATS 57 5 Home blood pressure variability 61 Maximum home SBP 61 SD of morning SBP 62 Morning orthostatic hypertension 64 6 Development of information technology-based new home blood pressure variability monitoring system 67 Disaster cardiovascular prevention network 67 Cutting-edge of HBPM 71 Basic nocturnal BP monitoring at home (Medinote) 71 Thermosensitive hypertension detecting home BP device 74 Trigger nocturnal BP monitoring 75 IT-based trigger nocturnal pressure monitoring system 81 Detection and management of OSAS using new IHOPE-TNP 82 7 Home blood-pressure-monitoring guided morning hypertension control 88 Non-specific treatment 88 Specific treatment 89 8 Blood-pressure-lowering characteristics of antihypertensive drugs 91 Diuretics 91 Calcium channel blockers 91 Amlodipine 92 Nifedipine 94 Cilnidipine 95 Azelnidipine 96 Angiotensin-converting enzyme inhibitors 96 Angiotensin-receptor blockers 98 Telmisartan 98 Candesartan 98 Olmesartan 99 Azilsartan 103 Alpha-adrenergic blockers and beta-adrenergic blockers 104 RAS inhibitor-based combination 106 9 Home and ambulatory blood-pressure-profile-based combination strategy 109 First-line therapy 109 Second-line therapy 109 Arterial stiffness type 109 Volume retention type 110 Third-line therapy 110 10 Management of resistant hypertension 111 Evaluation of resistant hypertension 111 Fourth-line therapy 111 Circadian medication 114 11 Era of renal denervation 115 Evidence of renal denervation 115 Hypothesis of perfect 24-hour BP control by renal denervation 116 12 Latest evidence of controlling morning hypertension: the HONEST study 118 Conclusion and perspectives 122 References 123 Index 135