José Ramón Fernández

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Patients with resistant hypertension present high prevalence of a non-dipper blood pressure pattern. Recent results indicate that non-dipping is related partly to the absence of 24-hour therapeutic coverage in patients treated with single morning doses. Accordingly, we investigated the impact of treatment time on the blood pressure pattern in 700 patients(More)
Methods based on periodic regression have been designed for the detection of periodic components in short, noisy, and nonequidistant time series (as they are usually present in medicine and biology). The procedure consists of fitting a set of (cosine) curves to the data, with the analyst choosing the domain of trial periods to be analyzed and the distance(More)
OBJECTIVE We prospectively investigated in hypertensive patients with type 2 diabetes if bedtime treatment with ≥1 hypertension medications exerts better blood pressure control and cardiovascular risk reduction than conventional therapy, in which all medications are ingested in the morning. RESEARCH DESIGN AND METHODS We conducted a prospective,(More)
Most variables of interest in laboratory medicine show predictable changes with several frequencies in the span of time investigated. The waveform of such nonsinusoidal rhythms can be well described by the use of multiple components rhythmometry, a method that allows fitting a linear model with several cosine functions. The method, originally described for(More)
AIMS/HYPOTHESIS We investigated whether therapy with the entire daily dose of ≥ 1 hypertension medications at bedtime exerts greater reduction in the risk of new-onset diabetes than therapy with all medications upon awakening. METHODS We conducted a prospective, randomised, open-label, blinded endpoint trial of 2,012 hypertensive patients without(More)
Valsartan administration at bedtime as opposed to on wakening improves the sleep time-relative blood pressure decline toward a more dipper pattern without loss in 24-hour efficacy. Yet to be determined is whether this administration time-dependent efficacy is a class-related feature, characteristic of all angiotensin receptor blockers or specific only to(More)
During waking h, the existence of ultradian rhythms in gross motor activity has been described in nonprimates, nonhuman primates and newborn humans, but not in adult humans. Some of the previous studies suggested that the appearance of these rhythms could be favored by conditions of isolation and low environmental demands. To confirm the existence of(More)
We have examined prospectively whether the combined approach of establishing tolerance intervals for the circadian variability of blood pressure (BP) as a function of gestational age, and then determining the so-called hyperbaric index (area of BP excess above the upper limit of the tolerance interval) by comparison of any patient's BP profile (obtained by(More)
We review the potential limitations of the two current methodologies for evaluating the duration of action of antihypertensive therapy: the smoothness index (SI) and the trough : peak ratio (TP). We propose a simple correction factor for the SI. The correction factor prevents the SI from reaching erroneous high values in situations in which the reduction in(More)
We describe a novel algorithm for identification of activity/rest periods based on actigraphy signals designed to be used for a proper estimation of ambulatory blood pressure monitoring parameters. Automatic and accurate determination of activity/rest periods is critical in cardiovascular risk assessment applications including the evaluation of dipper(More)