Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Association of Dipping Pattern or Early Morning Surge of BP With Asymptomatic Episodes of Paroxysmal Atrial Fibrillation in Subjects With Hypertension (DIMOSPAF)

Eligibility criteria:
Inclusion Criteria:

          -  Patients diagnosed with essential HTN (office BP>140/90mmHg) or patients receiving at
             least one antihypertensive medication (ie. RAAA inhibitors or diuretic), aged 18-85
             years of age.

          -  Patients with at least one of the following risk factors, organ damage or other
             evidence of cardiovascular disease:

          -  Previous stroke

          -  Transient ischemic attack (TIA)

          -  Systemic embolism

          -  Diabetes mellitus type 2

          -  Obesity

          -  Obstructive sleep apnea (OSA)

          -  Dyslipidemia

          -  History of coronary artery disease (CAD)

          -  Valvular heart disease (VHD)

          -  Echocardiographic findings attributed to HTN (ie. diastolic dysfunction, LVH)

          -  White coat hypertension (WCH), masked hypertension (MH)

          -  Positive family history for rhythm disturbances

        Exclusion Criteria:

          -  Patients already diagnosed with paroxysmal or permanent AF

          -  Severe renal insufficiency (eGFR according to MDRD formula <25ml/min/1.73m2)

          -  Patients unable to attend follow-up visits

          -  Clinical evidence of severe heart failure

          -  Suspected secondary HTN

          -  Mental disorders

          -  Patients with cancer
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Entailment