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There are increasing data supporting evening administration as a means of achieving better BP control through re-establishing normal sleeping dipping patterns, thereby preventing the development of comorbidities. Additionally, this dosing change has been shown to prevent the morning surge, a precursor to negative cardiovascular (CV) events, including heart attack and stroke. When the costs are high both fiscally and medically, simple and cost-free interventions should be the first-line treatments.
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Moderate and/or severe protein restrictions may indeed, be proposed in chronic renal failure both to fight its symptoms and to slow its progression. In diabetic patients, whether insulin-dependent or non-insulin-dependent, have a chronic disease that has generally existed for a number of years before the onset of renal failure.
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