Successes and challenges of chronotherapy of hypertension in the Polar monthly rotational shift-workers
Current perspectives and challenges of chronotherapeutic strategy in monthly rotational shift-workers of arctic, Yamburg (Yamal) were analyzed. Chronotherapy proved to have higher effectiveness by comparison to non-personified treatment in reducing office and 24-hour ambulatory monitored blood pressure, improving the parameters of circadian rhythm and also revealed to be beneficial in terms of clinical course of hypertension. On the other hand, some still unresolved challenges, limiting a broader use of this progressive method and as yet preventing chronotherapy from absorbing of standard treatment strategy, were identified and analyzed. It included the complexity of chronobiologic algorithm itself, needed for correct interpretation and control of treatment and its outcome, low patient's compliance with prescribed chronotherapeutic regimens, and diversity of physiologic and chronopharmacologic background mechanisms, which make interpretation of chronotherapy with drugs of different groups a tougher task.