Patients with daytime hypertension who had a nocturnal dipping pattern had a relative risk of 3.70 (95% confidence interval, 1.13–12.5) and those with a nondipping pattern had a relative risk of CV events of 6.26 (95% CI, 1.92–20.32) when compared with those with white‐coat hypertension. 13 Verdecchia and colleagues compared patients with only white‐coat hypertension with those with ambulatory hypertension.
The lack of a drop in BP at night (nondippers) increases CV risk.
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Studies have demonstrated that sleeptime BP is a better predictor of CV events than daytime pressures or full 24‐hour results. 10 The most plausible explanation for this observation is that ABPM provides measurements during the critical nighttime period. Target organ damage and CV events are predicted more reliably by 24‐hour ambulatory BP monitoring (ABPM) than office measurements. Normal nighttime BPs are <120/70 mm Hg, while they are <135/85 mm Hg for daytime pressures and <130/80 mm Hg for the entire 24‐hour period. The drop during sleep is called nighttime dipping and is defined as a drop in systolic BP ≥10%. BP plateaus throughout the afternoon and declines dramatically in most individuals during sleep. 9 The latter effect is sometimes called early morning BP surge. It has been known for nearly 50 years that BP exhibits circadian variability with a rapid increase on arising in the morning. This study will determine whether nighttime dosing reduces CV risk when compared with traditional morning dosing of antihypertensive agents. Patients will be followed for 36 to 42 months. Patients with hypertension and other comorbid conditions will be randomized to either continue morning dosing of all antihypertensive agents or to switch their nondiuretic medications to bedtime dosing.
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The authors describe a randomized controlled pragmatic trial that is being planned at the University of Iowa and Duke University. Some authors have suggested that additional studies of nighttime dosing of antihypertensive agents that evaluate CV events need to be conducted.
However, several evaluations in ophthalmology have found that nocturnal arterial hypotension precipitated ocular vascular disorders such as ischemic optic neuropathy. A Cochrane review of 5 studies found no difference in adverse events between morning and evening dosing. One small study and 2 substudies of diabetes and chronic kidney disease suggest that bedtime dosing of ≥1 antihypertensives significantly reduced CV events. Several studies have found that bedtime dosing of antihypertensive agents reduces sleep blood pressure and improves the dipping pattern in nondippers. Adults with hypertension who lack a nighttime dipping pattern are at particularly high risk. Also, I hope that official forums will get much more attention now and be brought up to speed ASAP.Blood pressure exhibits circadian variability, and nighttime blood pressure is one of the best predictors of cardiovascular ( CV) events. Please make sure you support these guys, they did their best and the opponent is much more powerful than anybody thought. The hack might produce phishing attempts of other nature as well so be extra careful about links in emails from sources you are not familiar with.Īion Source forum was the largest gathering place for the Aion community and people at Aion Source did a huge service for the Aion community. If you have been a member of that forum please make sure that you do not click on any links whatsoever if you receive Aion related emails. Your safety and ability to use our website worry-free is our top priority We value your time, and assure you we are doing everything in our power to prevent problems like this from affecting our network in the future.
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DO NOT TRUST ANY EMAIL LINK that is related to your password for Aion Online or, always open your browser and type in the website address manually… We’ve comprised a list of ways to protect yourself and what to be on the look out for. We always value your safety, and strive to maintain your trust. It has come to our attention that during a recent attempt to hack our website, hackers may have gained access to email addresses used to register accounts here at. All Aion Source forum members just received an email with the following contents:
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