open access

Vol 26, No 2 (2022)
Original paper
Published online: 2021-08-12
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Effect of intermittent fasting and chronotherapy on blood pressure control in hypertensive patients during Ramadan

Ihsen Zairi1, Mohamed Amine Bejar1, Imtinen Ben Mrad1, Khadija Mzoughi1, Sondos Kraiem1
DOI: 10.5603/AH.a2021.0019
·
Arterial Hypertension 2022;26(2):67-72.
Affiliations
  1. Department of Cardiology, Habib Thameur Hospital, University Tunis El Manar, Tunis, Tunisia

open access

Vol 26, No 2 (2022)
ORIGINAL PAPERS
Published online: 2021-08-12

Abstract

Background: During Ramadan, repeated cycles of fasting, associated with alterations in the daily patterns of sleep, activities and medication timing might contribute to changes in blood pressure (BP) and heart rate among hypertensive patients. Studies on the effects of fasting on the blood pressure of hypertensive patients are rare, and have provided inconclusive results. The aim of this study was to examine the effect of medication timing during Ramadan on blood pressure and heart rate in hypertensive individuals taking their treatment once daily.

Material and methods: The study prospectively recruited 44 hypertensive patients between April and June 2019, followed up at the cardiology department of Habib Thameur Hospital in Tunis. A 24-hour blood pressure monitoring was carried out during two periods: prior to Ramadan and during the last ten days of Ramadan. We compared the average values of 24-hour awake and asleep systolic and diastolic blood pressure and 24-hour awake and asleep heart rate.

Results: We studied 29 women and 15 men, mean age was 58.7 years. Fifteen patients were diabetics, 20 had dyslipidemia and 7 patients had coronaropathy. Twenty patients were on monotherapy, 19 on dual therapy and 5 on
a triple antihypertensive therapy. During Ramadan, 25 patients took their treatment during the dinner (group1), whereas 19 took their treatment during the S’hour (group 2). Average 24-hour blood pressure in the whole group was 129 ± 18/74 ± 10 mm Hg before Ramadan and 129 ± 19/74 ± 10 mm Hg during Ramadan (p > 0.05). Daytime and night-time mean values of systolic and diastolic blood pressure as well as mean values of heart rate were not different between both periods regardless of age and gender. However, during Ramadan, those who took their treatment after dinner had significantly higher values of 24-hour systolic BP, awake systolic and diastolic BP, asleep systolic and diastolic BP than those who took their treatment with the S’hour (p < 0.05).

Conclusions: In this study, there were no significant changes in systolic and diastolic blood pressures or in heart rate during the 2 periods. However, during Ramadan, a slight superiority of taking the treatment with the S’hour is observed.

Abstract

Background: During Ramadan, repeated cycles of fasting, associated with alterations in the daily patterns of sleep, activities and medication timing might contribute to changes in blood pressure (BP) and heart rate among hypertensive patients. Studies on the effects of fasting on the blood pressure of hypertensive patients are rare, and have provided inconclusive results. The aim of this study was to examine the effect of medication timing during Ramadan on blood pressure and heart rate in hypertensive individuals taking their treatment once daily.

Material and methods: The study prospectively recruited 44 hypertensive patients between April and June 2019, followed up at the cardiology department of Habib Thameur Hospital in Tunis. A 24-hour blood pressure monitoring was carried out during two periods: prior to Ramadan and during the last ten days of Ramadan. We compared the average values of 24-hour awake and asleep systolic and diastolic blood pressure and 24-hour awake and asleep heart rate.

Results: We studied 29 women and 15 men, mean age was 58.7 years. Fifteen patients were diabetics, 20 had dyslipidemia and 7 patients had coronaropathy. Twenty patients were on monotherapy, 19 on dual therapy and 5 on
a triple antihypertensive therapy. During Ramadan, 25 patients took their treatment during the dinner (group1), whereas 19 took their treatment during the S’hour (group 2). Average 24-hour blood pressure in the whole group was 129 ± 18/74 ± 10 mm Hg before Ramadan and 129 ± 19/74 ± 10 mm Hg during Ramadan (p > 0.05). Daytime and night-time mean values of systolic and diastolic blood pressure as well as mean values of heart rate were not different between both periods regardless of age and gender. However, during Ramadan, those who took their treatment after dinner had significantly higher values of 24-hour systolic BP, awake systolic and diastolic BP, asleep systolic and diastolic BP than those who took their treatment with the S’hour (p < 0.05).

Conclusions: In this study, there were no significant changes in systolic and diastolic blood pressures or in heart rate during the 2 periods. However, during Ramadan, a slight superiority of taking the treatment with the S’hour is observed.

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Keywords

hypertension; fasting; ambulatory blood pressure monitoring; chronotherapy

About this article
Title

Effect of intermittent fasting and chronotherapy on blood pressure control in hypertensive patients during Ramadan

Journal

Arterial Hypertension

Issue

Vol 26, No 2 (2022)

Article type

Original paper

Pages

67-72

Published online

2021-08-12

Page views

1918

Article views/downloads

227

DOI

10.5603/AH.a2021.0019

Bibliographic record

Arterial Hypertension 2022;26(2):67-72.

Keywords

hypertension
fasting
ambulatory blood pressure monitoring
chronotherapy

Authors

Ihsen Zairi
Mohamed Amine Bejar
Imtinen Ben Mrad
Khadija Mzoughi
Sondos Kraiem

References (18)
  1. Al-Arouj M, Assaad-Khalil S, Buse J, et al. Recommendations for management of diabetes during Ramadan: update 2010. Diabetes Care. 2010; 33(8): 1895–1902.
  2. Ababou M, Ababou R, Maliki AEl. Le jeûne du Ramadan au Maroc : un dilemne pour les patients diabétiques et les soignants. Sci Soc Santé. 2008; 26(2): 79–104.
  3. Ramirez LA, Sullivan JC. Sex Differences in Hypertension: Where We Have Been and Where We Are Going. Am J Hypertens. 2018; 31(12): 1247–1254.
  4. Williams B, Mancia G, Spiering W, et al. ESC Scientific Document Group . 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021–3104.
  5. Younus A, Aneni EC, Spatz ES, et al. A Systematic Review of the Prevalence and Outcomes of Ideal Cardiovascular Health in US and Non-US Populations. Mayo Clin Proc. 2016; 91(5): 649–670.
  6. Kapetanakis VV, Rudnicka AR, Wathern AK, et al. Adiposity in early, middle and later adult life and cardiometabolic risk markers in later life; findings from the British regional heart study. PLoS One. 2014; 9(12): e114289.
  7. Kuwabara M, Kuwabara R, Niwa K, et al. Different Risk for Hypertension, Diabetes, Dyslipidemia, and Hyperuricemia According to Level of Body Mass Index in Japanese and American Subjects. Nutrients. 2018; 10(8).
  8. Lee CY, Lin WT, Tsai S, et al. Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents. Nutrients. 2016; 8(9).
  9. Crawford AG, Cote C, Couto J, et al. Prevalence of obesity, type II diabetes mellitus, hyperlipidemia, and hypertension in the United States: findings from the GE Centricity Electronic Medical Record database. Popul Health Manag. 2010; 13(3): 151–161.
  10. Biad A, Chibane A, Makhlouf L, et al. Prévalence of diabetes and hypertension in the east of Algiers. J Hypertens. 2010; 28: e318–e319.
  11. de Boer IH, Bangalore S, Benetos A, et al. Diabetes and Hypertension: A Position Statement by the American Diabetes Association. Diabetes Care. 2017; 40(9): 1273–1284.
  12. Egan BM, Li J, Qanungo S, et al. Blood pressure and cholesterol control in hypertensive hypercholesterolemic patients: national health and nutrition examination surveys 1988-2010. Circulation. 2013; 128(1): 29–41.
  13. Wagner A, Arveiler D, Ruidavets JB, et al. Etat des lieux sur l'hypertension artérielle en France en 2007: l'étude Mona Lisa. Bull Epidémiol Hebdomadaire. 2008(49–50): 483–486.
  14. Biaggioni I. Circadian clocks, autonomic rhythms, and blood pressure dipping. Hypertension. 2008; 52(5): 797–798.
  15. Bendersky M. Cronoterapia en hipertensión arterial. Hipertens Riesgo Vasc. 2015; 32(3): 119–124.
  16. Mallion JM, de Gaudemaris R, Monzie A, et al. [Arterial pressure and shift work activities]. Arch Mal Coeur Vaiss. 1987; 80(6): 897–904.
  17. Hermida RC, Ayala DE, Mojón A, et al. Influence of circadian time of hypertension treatment on cardiovascular risk: results of the MAPEC study. Chronobiol Int. 2010; 27(8): 1629–1651.
  18. Mzoughi K, Zairi I, Mroua F, et al. Les effets du jeûne du mois de Ramadan sur la pression artérielle chez les hypertendus traités Effects of Ramadan fasting on blood pressure in treated hypertensive patients. Cardiol Tunis. 2016; 12(3): 167–173.

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