Larry A. Beaty

Season's appreciations

To follow the tradition set by the late Franz Halberg, highlights of research performed over the last year from his Minnesota Center are summarized. They illustrate the broad international cooperation enjoyed by his center and the diversity of applications of the discipline he founded. The results briefly summarized herein in the form of an annotated bibliography are a testimony that his legacy continues to live on and constitutes a tribute to his memory.

Chronobiologically Interpreted Ambulatory Blood Pressure Monitoring in Health and Disease

To detect vascular variability anomalies (VVAs), a blood pressure and heart rate profile around the clock for at least 7 days is a start. As a minimum, measurement every 60 or preferably 30 minutes for a week is needed, to be continued if abnormality is found, to assess the about 24-hour (circadian) variability that exists in all individuals. As a first dividend, one then also obtains a glimpse of 2 of the very many longer-than-circadian periodicities, the biological half-week and week. Certainly if we can have sensors and computer chips in our cars that continuously monitor the pressure over a tires life, we should be able to do the same job for ourselves for diagnostic and therapeutic decisions. Healthcare today emphasizes wellness with recommendations for exercise and a proper diet, yet these evaluations may not be adequate. BP may be measured at a visit to the doctor or before an exercise session, along with measuring body weight and performing a physical exam. The seeds of disease are planted long before they are visible, and what appears to be normal from a conventional point of view may in fact be abnormal. Hidden alterations of physiological function, masked by the bodys remarkable adaptive capabilities, may become visible through a new diagnostic and therapeutic realm—-chronobiology—-that reveals hitherto unseen abnormalities. The tools of chronobiology may yield additional dividends, such as the detection of physiological “loads” related to stress and stress relief and the undesirable effects of space weather upon personal events such as sudden cardiac death, societal events like terrorism and war, and natural disasters. Chronobiologically interpreted automatic ambulatory BP and heart rate (HR) monitoring (C-ABPM) may detect the antecedents of these types of events. C-ABPM is of interest in preventive cardiology, since it reveals new diagnoses as vascular variability anomalies (VVAs) and renders previous conventional diagnoses more reliable, such as that of an elevated BP. These VVAs include MESOR (midline-estimating statistic of rhythm)-hypertension, an elevation of the MESOR, which is diagnosed, like all other VVAs, only after 1 or preferably several replications of 7-day around-the-clock BP monitoring with available, affordable, and unobtrusive instrumentation. The recommendation for continuous C-ABPM recognizes several principles that constitute inseparably intertwined contributors to severe cardio-, cerebro- and renovascular diesase. C-ABPM gauges wear and tear of genetics, physical loads, and in particular mental stress placed upon individuals from “womb to tomb” by daily life, including weather in extraterrestrial space as well as that on earth, as a continuous surveillance paradigm preventing us from flying blind to a change from less than 5% to near 100% in the risk of a stroke within 6 years.

Chronobiologically interpreted ambulatory blood pressure monitoring: past, present, and future

ABSTRACT Research at the Halberg Chronobiology Center focused to a large extent on the monitoring of blood pressure (BP) and heart rate (HR). Self-measurements and later ambulatory BP monitoring yielded new knowledge of interest to basic science and clinical practice. After a brief review of BP measurement, we outline developments in methods of data analysis that paralleled technological advances in the measurement of BP. We review work done in cooperation with colleagues worldwide to illustrate how a chronobiological approach led to the mapping of spontaneous circadian and other rhythms for the derivation of refined reference values and to the assessment of response rhythms underlying chronotherapy. BIOCOS members work in different fields, spanning from cardiology and nutrition to obesity, diabetes, exercise physiology and rehabilitation, but all strive for “pre-habilitation”. The early recognition of increased risk can prompt the timely institution of prophylactic intervention. As technology continues to improve, studies on groups are complemented by longitudinal self-surveillance for health maintenance. Longitudinal records serve for the investigation of environmental influences on human physiology, the topic of chronomics. As current advances in technology and wireless communication will likely impact the future of healthcare, chronobiological methods and concepts should be an integral part of this seachange.