100 or 30 years after Janeway or Bartter, Healthwatch helps avoid 'flying blind'.

摘要: Longitudinal records of blood pressure (BP) and heart rate (HR) around the clock for days, weeks, months, years, even decades obtained by manual self-measurements (during waking) and/or automatically ambulatory monitoring reveal, in addition to well-known large within-day variation, also considerable day-to-day variability most people, whether normotensive or hypertensive. As a first step, circadian rhythm is considered along with gender differences changes as function age derive time-specified reference values (chronodesms), while accumulate account circaseptan variation. Chronodesms serve interpretation single measurements other parameters. Refined diagnoses can thus be obtained, namely MESOR-hypertension when chronome-adjusted mean value (MESOR) BP above upper limit acceptability, excessive pulse (EPP) difference MESOR between systolic (S) diastolic (D) too large, CHAT (circadian hyper-amplitude tension) amplitude excessive, DHRV (decreased variability) standard deviation (SD) HR below acceptable range, ecphasia overall high recurring each day occur at an odd time (a condition contributing risk associated 'non-dipping'). A non-parametric approach consisting computer comparison subject's profile time-varying limits acceptability further serves guide optimize efficacy any needed treatment timing its administration (chronotherapy) selecting schedule best suited normalize abnormal patterns HR. The merit proposed chronobiological screening, diagnosis therapy (chronotheranostics) assessed light outcome studies. Elevated variability, if not all lie within range values, becomes amenable critical step toward prevention (prehabilitation) reduce need rehabilitation (the latter often after costly surgical intervention).