Chronobiology and chronotherapeutics. Applications to cardiovascular medicine.
نویسنده
چکیده
The concept of homeostasis, ie, constancy of the milieu interne, has dominated the teaching, research, and practice of medicine during the 20th century. According to this theory, biologic functions and processes are maintained in relative constancy over time. The emerging concepts of chronobiology, the scientific discipline of biologic rhythm study, and the findings from research in this field challenge the construct of homeostasis. Epidemiology studies document that the occurrence and exacerbation of many human diseases vary predictably in time over 24 h, the menstrual cycle, and year due to underlying rhythms of corresponding period. Advances in the chronobiology of cardiovascular disease have proceeded rapidly during the past decade and have influenced the manner in which diagnostic procedures are conducted and interpreted. Twenty-four-hour ambulatory blood pressure (BP) monitoring and Holter monitoring reveal the marked circadian (24-h) rhythms in BP in hypertensive patients and electrocardiographic events in patients with ischemic heart disease. Homeostatically devised pharmacotherapies, ie, medications designed to ensure constant drug levels over time, may be inadequate to optimally control diseases whose courses vary in risk or severity during the 24-h period. Chronotherapies--medications formulated to deliver varying amounts of drug at different times during the 24 h period to correlate with biologic need--theoretically could offer improved efficacy. A chronotherapy for cardiovascular disease already exists in the form of the evening administration for lipid-lowering medications. The chronotherapy for hypertension and of ischemic heart disease is forthcoming.
منابع مشابه
Deterministic mathematical modelling for cancer chronotherapeutics: cell population dynamics and treatment optimisation
Chronotherapeutics has been designed and used for more than twenty years as an effective treatment against cancer by a few teams around the world, among whom one of the first is Francis Lévi’s at Paul-Brousse hospital (Villejuif, France), in application of circadian clock physiology to determine best infusion times within the 24-hour span for anticancer drug delivery. Mathematical models have b...
متن کاملEffective factors on sleep satisfaction and chronobiology among rural adults
Background: Regarding this, the present study was conducted to identify the effective factors on sleep satisfaction and chronobiology among rural adults. Materials and Methods: This cross-sectional study was conducted on 385 adults how living in 31 rural areas of Fariman city, Iran, selected through stratified sampling technique. The sample size was calculated using a conservative approach with...
متن کاملFrom the basic neuroscience of circadian clock function to light therapy for depression: on the emergence of chronotherapeutics.
Biological psychiatry seeks to establish the genetic, neurochemical, and physiological basis of mental disorders and their treatments. Chronobiology, or biological rhythm research, has made a set of discoveries in recent years across these same levels of functional organisation. And psychiatric chronotherapeutics is the fast-growing application of circadian principles in treating mood and sleep...
متن کاملChronotherapeutics in a psychiatric ward.
Psychiatric chronotherapeutics is the controlled exposure to environmental stimuli that act on biological rhythms in order to achieve therapeutic effects in the treatment of psychiatric conditions. In recent years some techniques (mainly light therapy and sleep deprivation) have passed the experimental developmental phase and reached the status of powerful and affordable clinical interventions ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- American journal of hypertension
دوره 9 4 Pt 3 شماره
صفحات -
تاریخ انتشار 1996