الفهرس 
Circadian Rhythm of blood pressureOnly 14 pages are availabe for public view
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Abstract
Although digoxin failed to show an effect on reduction of mortality in patients with heart failure and sinus rhythm, recent studies are searching for a role for digoxin in this group of patients. Aim of the work: The aim of this study was to study, the circadian rhythm changes of blood pressure in patients with congestive heart failure, and the effect of digoxin on circadian rhythm of blood pressure in patients with congestive heart failure. Patients and methods: Twenty five normotensive patients with congestive heart failure and EF less than 40 % took digoxin for fourteen days, ambulatory blood pressure monitoring was carried out twice for each patient, once before the administration and the second one was after fourteen days of treatment with digoxin. Results: Twenty percent of patients were non dippers. After administration of digoxin the percentage of dippers increased to 36%. Mean dipping of MAP of the 25 five patients increased significantly after administration of digoxin from 6.44% ± 4.1before digoxin, to 7.996 % ± 3.4 after digoxin administration. P value < 0.05. Diastolic blood pressure during night sleep significantly decreased, from 71.44 mmHg ± 5.6 before digoxin to 68.16 mmHg ±5.2 after digoxin administration. P value < 0.001. Systolic blood pressure significantly increased during night sleep from 106.64 mmHg ± 8.4 before digoxin to 109.96 mmHg ± 9.6 after digoxin administration . P value < 0.05 .Awake systolic and diastolic blood pressure showed non significant changes after administration of digoxin. Awake and sleep mean blood pressure showed non significant changes after administration of digoxin. Awake heart rate decreased significantly from 90.6 bpm ± 11.7 before digoxin to 87.12 bpm ± 11.0917 after digoxin administration. P value < 0.001. Sleep heart rate decreased significantly from 82.96 bpm ± 10.5 before digoxin and 76.52 bpm ± 11.47 after digoxin administration. P value < 0.001. Heart rate reduction increased significantly from 8.12 % ± 5.9 before digoxin to 12.16 % ± 5.27 after digoxin administration. P value < 0.05. Conclusion: from the present study we conclude that digoxin increased the dipping of mean arterial blood pressure and increased the number of dippers among patients with congestive heart failure.