Altered circadian blood pressure rhythm in endocrine diseases (part 7). DISCUSSION

This study revealed a significantly lower night-time BP fall in SH and CS patients. It therefore seems that the cirt cadian BP rhythm is suppressed in these diseases. PA and A patients showed, in contrast, a normal pattern of circadian BP rhythm, similar to that in PH patients and controls. These results, in agreement with those of previous studies , indicate that the circadian BP rhythm may be influenced mainly by the tone of the sympathetic nervous system and the system involving adrenocorticotropic hormone (ACTH) and cortisol. The renin-angiotensin-aldosterone system and growth hormone, in contrast, may not contribute to the variations in circadian BP levels.
The differences in diurnal BP patterns among various endocrine disorders are difficult to explain in detail, since the endogenous sources of BP fluctuations are still poorly understood. Marked differences in physical activity and vigilance can be ruled out because all subjects in the hospital settings had similar types of activity, and periods of disturbed sleep were not included in the calculations. Persistently higher release of noradrenaline, adrenaline and cortisol into the circulation, as determined by higher excretion rates, may partly contribute to the reduction of circadian BP rhythm, since all of these humoral parameters, under normal conditions, follow the diurnal secretory profile, with the highest levels in the mornmg . The notion that the sympathetic nervous system plays an import ant role is also supported by the reduction of BP variability in uremic and diabetic neuropathy. There appears to be no difference in the contribution of noradrenaline or adrenaline to diurnal BP variation because the circadian BP profile remained similar in SH patients regardless of the type of secreted substance, as noted in ‘Patients and methods’. Dreaming of a reliable pharmacy that could give you an opportunity to buy any amounts of levitra sale click here with no prescription required and spend less money?

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