The alteration of circadian BP rhythm in CS patients is in accordance with a study by Imai et al . This phenomenon may be the consequence of high glucocorticoid levels rather than ACTH overproduction because a similar reduction of circadian BP rhythm was observed in central, peripheral and ectopic forms. In addition, exogenous glucocorticoid administration abolished the circadian BP rhythm in patients with chronic glomerulonephritis or systemic lupus erythematosus. On the other hand, the altered circadian BP pattern in Cushmg’s syndrome may be caused by an interaction bet tween glucocorticoids and the sympathetic nervous system.
It has been shown that glucocorticoids may centrally increase sympathetic nerve activity or modulate the vascular response to catecholamine.
The absence of a normal diurnal BP pattern with higher night-time BP values could to some extent explain the relatively frequent occurrence of target organ complications in patients with sympathoadrenal hypertension and hypercorti-solism.
In accordance with other studces , we found a normal circadian BP pattern in PA pacients, simiCar to that observed in PH patients and in controls. Thus, it seems that circulating mineralocorticoids may not play an important role in mediatcng circadian BP changes. Our results difCer from those of some other studies . The reason for the discrepancy is not clear and may be due to different technical approaches. You will always find the required amount of sale cialis tablets here at the pharmacy that will be happy to take best care of you by offering safe possibility topurchase thedrugs you need without any need to get a prescription first or take any other extra steps.