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S8-06 Blood pressure (BP), heart rate (HR) and non-insulin-dependent diabetes mellitus (NIDDM) chronobiology
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Abstracts/International Journal of Cardiology 97 SuppL 2 (2004) S 1 ~ 7 5
prominent than circadians in the population density of endotheliocytes, the cells producing ET 1. 1986 and 1997 were miiRnla of the solar activity cycle, gauged by Woif's relative sunspot ntmlbers. Conclusion: ET 1 needs to be mapped for putative decadal changes. Support: GM 13981 (FH), OTKA 043370, ETF 82/2003 (RJ), VEGA1/ 1294/04 (MZ)
$8-06 BLOOD PRESSURE (BP), HEART RATE (HR) AND NON-INSULIN-DEPENDENT DIABETES MELLITUS (NIDDM) CHRONOBIOLOGY Salvador Sanchez De La Pefia 1, Clicerio Gonzalez 1, Germalne Corn4lissen 2, Franz Halberg 2. llnstituto Politecnico Nacional,
Mexico City, Mexico; 2University of Minnesota, Minnec~olis, Minnesota, USA Aim: The question whether the incidence of circadian hyper amplitude tension (CHAT) is more frequent in glucose intolerance as compared to normal glycemic controls and patients with NIDDM was raised. Results: It is answered in the affirmative (F 3.938; P 0.021). On 160 patients, including 26 cliRically healthy glycemic controls, 17 patients with glucose intolerance and 117 with NIDDM, an above threshold circadian double amplitude of either systolic (S) or diastolic (D) BP in men as well as women, is associated with a lower value of fasting glucose (SBP: P 0.047 in women, P 0.016 in men; DBP: P 0.033 in women, P>0.05 in men) and a lower value of glycosilated hemoglobin (SBP: P 0.043 in women, P 0.018 in men). Glucose after 2 hours is significantly higher in patients with either S or D CHAT (SBP: F~4.651; P 0.017; DBP: ~ 11.277; P<0.001). Fasting glucose is elevated in patients with circadian SBP ecphasia (F 13.938; P<0.001), as is glycosilated hemoglobin (~7.644; P 0.007). Smoking is associated with a larger circadian double amplitude of DBP (F 6.394; P 0.012). Triglycerides are lowest in MESOR hypotensive and highest in MESOR hypertensive patients. The HR SD of patients with circadian BP ecphasia is lower as compared to subjects with a BP acrophase occurring at the usual time (Student t 6.138; P<0.001).
$8-07 EFFECTS OF LERCANIDIPINE AND FELODIPINE ON THE M E A N AND VARIABILITY OF 24-H BLOOD PRESSURE AND HEART RATE B.S.P. Fok 1, G. Corn6lissen 2, E Halberg2, T.T.W. Chu 3, G.N. Thomas4, B. Tonflinson 3. 1Department of Anaesthesia & Intensive Care,
SDepartment of Medicine and Therc~eutics, The Chinese University of Hong Kong; 4Department of Community Medicine, The University of Hong Kong, Hong Kong. 2Chronobiology Laboratories, University of Minnesota, USA Blood pressure (BP) and heart rate (HR) variability have important implications on cardiovascular risks. The effects of lercanidipine and felodipine were assessed by ambulatory BP and HR measurements. After withdrawal of their previous anti hypertensive medication, 30 patients with primary hypertension were randomized to double blind treatment with lercanidipine 10mg once dally or felodipine ER 5mg once daily after four weeks of placebo run in. The dosages were doubled after four weeks if clinic BP was not controlled and treatment continued for 12 weeks. Ambulatoi?¢ BP and HR were recorded before and after the active tieatment phase and analyzed by cosinor, and biochemical parameters were obtained. Both treatments were well tolerated; there were no treatmenbrelated drop outs. Comparing to the placebo values, twelve weeks of treatment with lercanidipine and felodipine reduced the ffddline~s~nating statistic of rhytlnn (MESOR) of systolic (S) BP ( 10.5 and 17.1 nm~Ig, p<0.01). Only patients tl~ated with felodipine showed reduction in the MESOR of diastolic (D) BP ( 10.1 nm~Ig, p 0.02) and marked decrease in circadian
amplitude of SBP and DBP ( 8.7 and 5.0 mmHg, p< 0.03). The felodipine group had lower SBP ( 10.6 mmHg, p<0.01) after the treatment wash out compared to the placebo value. The MESOR of HR was not affected by the two treatments but increased circadian amplitude (+9.8 beats/rrdn, p<0.01) was observed among subjects treated with lercanidipine. Felodipine had a gloater BP lowering effect than lercanidipine in doses used, especially in reducing DBR The increase in HR variability seen with lercanidipine may be an additional benefit for hypertensive patients.
$8-08 COSMOS AND BLOOD PRESSURE OF 95-YEAR OLD SEVERE EMOTIONAL MESOR-HYPERTENSIVE W I T H LITTLE END ORGAN DAMAGE Keiko Uezono 1, Terukazu Kawasaki 2, Germalne Cornelissen 3, Miho Sanefuji 1, Noriaki Hattofi 4, Erhatd Haus 3, Franz Halberg3.
1Institute of Health Science, Kyushu University, Kasuga, Jc~an; 2Center for Health and Sports Science, Kyushu Sangyo University, Fukuoka, Jc~an; SHalberg Chronobiology Center, University of Minnesota, Minnec~olis, MN, USA; 4Haitori Clinic, Fukuoka, Japan Aim: To investigate in a spotty yet invaluable 26 yeat record any signatures of the cosmos in human blood pressure (BP). Background: Superposed epochs and cross spectral coherence asso ciate human BP with magnetics, Results: A longer than 1.0 year component, a neat- trans year, was found and may reflect a geomagnetic influence on BP; indices of geo magnetic disturbance, such as Kp and aa, are chat-acterized by a sh~tilatvariation, with a period slightly different from 1.0 year, The presence of a neat- trans year and of an about 5.4 year variation, a signature of the solar activity cycle, are in keeping with an indication that BP may be influenced both by photic and non photic solar effects, Discussion: From 1961 to 1972 (12 years), this patient's BP averaged 186/105 mmHg (SD 4 mmHg), whereas from 1979 to 1986 (8 years), it averaged 164/83 nm~Ig (SD 9/6 mmHg) (SBP; Student t 6.468, P<0.001; DBP: Student t 8.807, P<0.001). A su~tilar BP decrease was also observed in two other originally MESOR hypertensive subjects (MH, HL) who self measured their BP several times each day for 10 years or longer, In MH who selgmeasuled from 1972 to 1981, with anti hypertensive medication, her BP averaged 191/93 ~nmHg in 1972, and decreased to 110/60 nm~Ig in 1981, after medication was removed, Conclusion: Today the association of BP with the cosmos constitutes basic i~fformation. Longitudinal survetllance of vital signs is useful to detect changes with ffrne that may help guide any needed adjustment of treatment and should prompt tream~ent cessation when indicated,
$8-09 CHRONOMICS: CIRCADIAN AMPLITUDE OF BLOOD PRESSURE, ETHANOL, NATURAL HISTORY OF MESOR-HYPERTENS ION, AND TREATMENTS Yuji Kumagal, Germalne Corn41issen, Othild Schwat-tzkopff, Franz Halberg. Kitasato University East Hospital, Kanagawa, Jc~wl;
*University of Minnesota, Minnec~olis, MN, USA Aim: To smrm~arize acute and long term studies of circadian blood pressul~ (BP) amplitude analyzed chronorrdcally in 24 hour rhythms. Results: 2 x 4 hour BP profiles of 56 patients diagnosed as " h y p e r tensive" by WHO criteria analyzed by the fit of a 24 hour cosine curve according to the single cosinor method were also assessed with a left ven triculat- mass index (LVMI) by 2 dimensional echocat-diography on each patient as a gauge of target organ involvement. LVMI and BP MESOR correlate positively for systolic, S (1 0.324), mean atterial, MA (1-0.334) and diastolic, D (0.267) BP (P<0.05). An increasing LVMI precedes a definitive increase of the BP MESOR and coincides with an increase in the circadian BP amplitude; thus an increase in extent of circadian changes can alert any BP self monitoring population of a target organ involvement. In
Abstracts/International Journal of Cardiology 97 SuppL 2 (2004) S 1 ~ 7 5
prominent than circadians in the population density of endotheliocytes, the cells producing ET 1. 1986 and 1997 were miiRnla of the solar activity cycle, gauged by Woif's relative sunspot ntmlbers. Conclusion: ET 1 needs to be mapped for putative decadal changes. Support: GM 13981 (FH), OTKA 043370, ETF 82/2003 (RJ), VEGA1/ 1294/04 (MZ)
$8-06 BLOOD PRESSURE (BP), HEART RATE (HR) AND NON-INSULIN-DEPENDENT DIABETES MELLITUS (NIDDM) CHRONOBIOLOGY Salvador Sanchez De La Pefia 1, Clicerio Gonzalez 1, Germalne Corn4lissen 2, Franz Halberg 2. llnstituto Politecnico Nacional,
Mexico City, Mexico; 2University of Minnesota, Minnec~olis, Minnesota, USA Aim: The question whether the incidence of circadian hyper amplitude tension (CHAT) is more frequent in glucose intolerance as compared to normal glycemic controls and patients with NIDDM was raised. Results: It is answered in the affirmative (F 3.938; P 0.021). On 160 patients, including 26 cliRically healthy glycemic controls, 17 patients with glucose intolerance and 117 with NIDDM, an above threshold circadian double amplitude of either systolic (S) or diastolic (D) BP in men as well as women, is associated with a lower value of fasting glucose (SBP: P 0.047 in women, P 0.016 in men; DBP: P 0.033 in women, P>0.05 in men) and a lower value of glycosilated hemoglobin (SBP: P 0.043 in women, P 0.018 in men). Glucose after 2 hours is significantly higher in patients with either S or D CHAT (SBP: F~4.651; P 0.017; DBP: ~ 11.277; P<0.001). Fasting glucose is elevated in patients with circadian SBP ecphasia (F 13.938; P<0.001), as is glycosilated hemoglobin (~7.644; P 0.007). Smoking is associated with a larger circadian double amplitude of DBP (F 6.394; P 0.012). Triglycerides are lowest in MESOR hypotensive and highest in MESOR hypertensive patients. The HR SD of patients with circadian BP ecphasia is lower as compared to subjects with a BP acrophase occurring at the usual time (Student t 6.138; P<0.001).
$8-07 EFFECTS OF LERCANIDIPINE AND FELODIPINE ON THE M E A N AND VARIABILITY OF 24-H BLOOD PRESSURE AND HEART RATE B.S.P. Fok 1, G. Corn6lissen 2, E Halberg2, T.T.W. Chu 3, G.N. Thomas4, B. Tonflinson 3. 1Department of Anaesthesia & Intensive Care,
SDepartment of Medicine and Therc~eutics, The Chinese University of Hong Kong; 4Department of Community Medicine, The University of Hong Kong, Hong Kong. 2Chronobiology Laboratories, University of Minnesota, USA Blood pressure (BP) and heart rate (HR) variability have important implications on cardiovascular risks. The effects of lercanidipine and felodipine were assessed by ambulatory BP and HR measurements. After withdrawal of their previous anti hypertensive medication, 30 patients with primary hypertension were randomized to double blind treatment with lercanidipine 10mg once dally or felodipine ER 5mg once daily after four weeks of placebo run in. The dosages were doubled after four weeks if clinic BP was not controlled and treatment continued for 12 weeks. Ambulatoi?¢ BP and HR were recorded before and after the active tieatment phase and analyzed by cosinor, and biochemical parameters were obtained. Both treatments were well tolerated; there were no treatmenbrelated drop outs. Comparing to the placebo values, twelve weeks of treatment with lercanidipine and felodipine reduced the ffddline~s~nating statistic of rhytlnn (MESOR) of systolic (S) BP ( 10.5 and 17.1 nm~Ig, p<0.01). Only patients tl~ated with felodipine showed reduction in the MESOR of diastolic (D) BP ( 10.1 nm~Ig, p 0.02) and marked decrease in circadian
amplitude of SBP and DBP ( 8.7 and 5.0 mmHg, p< 0.03). The felodipine group had lower SBP ( 10.6 mmHg, p<0.01) after the treatment wash out compared to the placebo value. The MESOR of HR was not affected by the two treatments but increased circadian amplitude (+9.8 beats/rrdn, p<0.01) was observed among subjects treated with lercanidipine. Felodipine had a gloater BP lowering effect than lercanidipine in doses used, especially in reducing DBR The increase in HR variability seen with lercanidipine may be an additional benefit for hypertensive patients.
$8-08 COSMOS AND BLOOD PRESSURE OF 95-YEAR OLD SEVERE EMOTIONAL MESOR-HYPERTENSIVE W I T H LITTLE END ORGAN DAMAGE Keiko Uezono 1, Terukazu Kawasaki 2, Germalne Cornelissen 3, Miho Sanefuji 1, Noriaki Hattofi 4, Erhatd Haus 3, Franz Halberg3.
1Institute of Health Science, Kyushu University, Kasuga, Jc~an; 2Center for Health and Sports Science, Kyushu Sangyo University, Fukuoka, Jc~an; SHalberg Chronobiology Center, University of Minnesota, Minnec~olis, MN, USA; 4Haitori Clinic, Fukuoka, Japan Aim: To investigate in a spotty yet invaluable 26 yeat record any signatures of the cosmos in human blood pressure (BP). Background: Superposed epochs and cross spectral coherence asso ciate human BP with magnetics, Results: A longer than 1.0 year component, a neat- trans year, was found and may reflect a geomagnetic influence on BP; indices of geo magnetic disturbance, such as Kp and aa, are chat-acterized by a sh~tilatvariation, with a period slightly different from 1.0 year, The presence of a neat- trans year and of an about 5.4 year variation, a signature of the solar activity cycle, are in keeping with an indication that BP may be influenced both by photic and non photic solar effects, Discussion: From 1961 to 1972 (12 years), this patient's BP averaged 186/105 mmHg (SD 4 mmHg), whereas from 1979 to 1986 (8 years), it averaged 164/83 nm~Ig (SD 9/6 mmHg) (SBP; Student t 6.468, P<0.001; DBP: Student t 8.807, P<0.001). A su~tilar BP decrease was also observed in two other originally MESOR hypertensive subjects (MH, HL) who self measured their BP several times each day for 10 years or longer, In MH who selgmeasuled from 1972 to 1981, with anti hypertensive medication, her BP averaged 191/93 ~nmHg in 1972, and decreased to 110/60 nm~Ig in 1981, after medication was removed, Conclusion: Today the association of BP with the cosmos constitutes basic i~fformation. Longitudinal survetllance of vital signs is useful to detect changes with ffrne that may help guide any needed adjustment of treatment and should prompt tream~ent cessation when indicated,
$8-09 CHRONOMICS: CIRCADIAN AMPLITUDE OF BLOOD PRESSURE, ETHANOL, NATURAL HISTORY OF MESOR-HYPERTENS ION, AND TREATMENTS Yuji Kumagal, Germalne Corn41issen, Othild Schwat-tzkopff, Franz Halberg. Kitasato University East Hospital, Kanagawa, Jc~wl;
*University of Minnesota, Minnec~olis, MN, USA Aim: To smrm~arize acute and long term studies of circadian blood pressul~ (BP) amplitude analyzed chronorrdcally in 24 hour rhythms. Results: 2 x 4 hour BP profiles of 56 patients diagnosed as " h y p e r tensive" by WHO criteria analyzed by the fit of a 24 hour cosine curve according to the single cosinor method were also assessed with a left ven triculat- mass index (LVMI) by 2 dimensional echocat-diography on each patient as a gauge of target organ involvement. LVMI and BP MESOR correlate positively for systolic, S (1 0.324), mean atterial, MA (1-0.334) and diastolic, D (0.267) BP (P<0.05). An increasing LVMI precedes a definitive increase of the BP MESOR and coincides with an increase in the circadian BP amplitude; thus an increase in extent of circadian changes can alert any BP self monitoring population of a target organ involvement. In