Antihypertensives’ Rock around the Clock

Although homeostasis is a commonly accepted concept, there is incontrovertible evidence that biological processes and functions are variable and that variability occurs in cycles. In order to explain and understand dysregulation, which has not been embraced by homeostatic principles, the allostatic model has emerged as the first serious challenge to homeostasis, going beyond its homeostatic roots.

Circadian rhythm is the predominant variation in the body, and it is a pattern according to which many physiological and pathological events occur. As there is strong experimental and clinical evidence that blood pressure fluctuations undergo circadian rhythm, there is equally strong evidence that targeted time therapy for hypertension provides a better outcome of the disease. The research has gone even further throughout the development and approval process for the use of pulsatile drug release systems, which can be considered as an option for an even more convenient dosage regimen of the medicines needed.

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Continue reading here: Rahić, O.; Tucak, A.; Sirbubalo, M.; Hindija, L.; Hadžiabdić, J. Antihypertensives’ Rock around the Clock. J 2021, 4, 62-81. https://doi.org/10.3390/j4010005

Conclusions

Research in the area of chronotherapy of hypertension continues, with recent studies supporting a chronotherapeutic approach to treating hypertension with conventional antihypertensives at bedtime [118]. However, the administration of systems with pulsatile release may be even more convenient for patients, having in mind that these delivery systems are specifically designed to adjust drug release to the circadian rhythm of blood pressure. The only disadvantage of using pulsatile release systems is that there are only four approved ones for the treatment of hypertension that contain either calcium channel blockers or β-adrenergic receptor blockers, narrowing down patients for whom they could be used. However, the light at the end of the tunnel brings novel therapeutic approaches in targeting the clock, but more importantly in targeting the time using biodegradable polymers or nanotechnology. Innovation in research is certainly the use of 3DP technologies to obtain tailored release profiles of antihypertensive drugs. It might as well be said that the future of hypertension therapy is in safe hands.

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