Evaluation of the effectiveness of drug treatment in patients with arterial hypertension and insomnia
https://doi.org/10.21886/2712-8156-2021-2-4-49-59
Abstract
Objective: chronic sleep disturbance is a comorbid condition with arterial hypertension, often combined with affective disorders, anxiety, depression. Forced sleep deprivation in patients with hypertension indicates a high activity of the renin‑angiotensin‑aldosterone system (RAAS) and desynchronosis of biological rhythms caused by a probable deficit in melatonin secretion during the night. Timely elimination of any pathological process associated with insomnia and arterial hypertension (AH) in the early stages of its development is a prerequisite for the effectiveness of therapy. Therefore, initial therapy should help neutralize the adverse effects of RAAS and improve the 24‑hour blood pressure (BP) profile. The aim of this study was to determine the therapeutic effect of monotherapy with an angiotensin converting enzyme (ACE) inhibitor, As well as in combination with a synthetic analogue of melatonin, on the course of hypertension and parameters of systemic hemodynamics in patients with first degree hypertension with insomnia at the onset of the disease. Combined therapy with an ACE inhibitor and a synthetic analogue of MT in patients with hypertension and insomnia was accompanied by an improvement in the clinical state, achievement of the target blood pressure level in most patients, positive dynamics of central blood pressure parameters and indicators reflecting the rigidity of peripheral arteries.
About the Authors
I. N. Vasilieva
I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Inna N. Vasilieva, Сand. Sci. (Med), Associate professor
Moscow
A. I. Chesnikova
Rostov State Medical University
Russian Federation
Russian Federation
Anna I. Chesnikova, Dr. Sci. (Med), Professor
Rostov-on-Don
O. S. Klimenkova
I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Olga S. Klimenkova, student
Moscow
A. M. Bikmetova
I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Aliya M. Bikmetova, Federal State Autonomous Educational Institution of Higher Education
Moscow
References
1. Стрыгин К. Н., Полуэктов М. Г. Инсомния. Медицинский совет. Неврология. 2017; (1):52–59. DOI. 10.21518/2079-701X-2017-0-52-58.
2. Khan M.S, Aouad R. The Effects of Insomnia and Sleep Loss on Cardiovascular Disease. Sleep Med Clin. 2017;12 (2):167–177. DOI: 10.1016/j.jsmc.2017.01.005.
3. Diallo I., Pak V. M. Metabolomics, sleepiness, and sleep duration in sleep apnea. Sleep Breath. 2020;24 (4):13271332. DOI: 10.1007/s11325-019-01969-2.
4. Burman D. Sleep Disorders: Insomnia. FP Essent. 2017;460:22– 28. PMID: 28845958.
5. Hoevenaar-Blom MP, Spijkerman AM, Kromhout D, van den Berg JF, Verschuren WM. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence: the MORGEN study. Sleep. 2011;34 (11):1487–92. DOI: 10.5665/sleep.1382.
6. Crea F. Stop smoking and sleep well to reduce cardiovascular risk. Eur Heart J. 2021; (42): 4097–4100. DOI:10.1093/eurheartj/ehab731.
7. Mahmood A, Ray M, Dobalian A, Ward KD, Ahn S. Insomnia symptoms and incident heart failure: a population-based cohort study. Eur Heart J. 2021;42 (40):4169–4176. DOI: 10.1093/eurheartj/ehab500.
8. Berger M, Solelhac G, Roche F, Heinzer R. Insomnia, a new modifiable risk factor for heart failure? Eur Heart J. 2021;42 (40):4177–4179. DOI: 10.1093/eurheartj/ehab570.
9. Thomas S., Calhoun D. Sleep, insomnia, and hypertension: current findings and future directions. J Am Soc Hypertens. 2017;11 (2):122–129. DOI: 10.1016/j.Jash.2016.11.008.
10. Li L., Gan Y., Zhou X., Jiang H., Zhao Y., Tian Q., et al. Insomnia and the risk of hypertension: A meta-analysis of prospective cohort studies. Sleep Med Rev. 2021; (56):101403. DOI: 10.1016/j.smrv.2020.101403.
11. Mohd Azmi NAS, Juliana N, Azmani S, Mohd Effendy N, Abu IF, Mohd Fahmi Teng NI, et al. Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System. Int J Environ Res Public Health. 2021;18 (2):676. DOI: 10.3390/ijerph18020676.
12. Lerner A. B., Case J. D., Takahashi Y., Lee T. H., Mori W. Isolation of melatonin, the pineal gland factor that lightens melanocytes. J. Am. Chem. Soc. 1958;80 (10):2587. DOI: 10.1021/ja01543a060
13. Axelrod J. Journey of a late blooming biochemical neuroscientist. J Biol Chem. 2003;278 (1):1–13. DOI: 10.1074/jbc.X200004200.
14. Ramirez A., Filho D. Melatonin and its Relationships with Diabetes and Obesity: A Literature Review. Curr Diabetes Rev. 2021;17 (7): e072620184137. DOI: 10.2174/1573399816666200727102357.
15. Atrooz F., Salim S. Sleep deprivation, oxidative stress and inflammation. Adv Protein Chem Struct Biol. 2020;119:309–336. DOI: 10.1016/bs.apcsb.2019.03.001.
16. Kruk J., Aboul-Enein B., Duchnik E. Exercise-induced oxidative stress and melatonin supplementation: current evidence. J Physiol Sci. 2021;71 (1):27. DOI: 10.1186/s12576-021-00812-2.
17. Jaworek A., Szepietowski J., Hałubiec P., wojaspelc A., Jaworek J. Melatonin as an Antioxidant and Immunomodulator in Atopic Dermatitis-A New Look on an Old Story: A Review. Antioxidants (Basel). 2021;10 (8):1179. DOI: 10.3390/antiox10081179.
18. Cui S. Y., Huang Y. L., Cui XY. A common neuronal mechanism of hypertension and sleep disturbances in spontaneously hypertensive rats: Role of orexinergic neurons. Prog Neuropsychopharmacol Biol Psychiatry. 2020;100:109902. DOI: 10.1016/j.pnpbp.2020.109902.
19. Reiter R., Tan D., Rosales-Corral S Galano A, Zhou X., Xu B. Mitochondria: Central Organelles for Melatonin’s Antioxidant and Anti-Aging Actions. Molecules. 2018;23 (2):509. DOI:10.3390/molecules23020509.
20. Osadchuk M. A., Vasil’eva I. N., Mironova E. D., Khudarova A. A., Korzhenkov N. P. Corrective effect of angiotensin-converting enzyme inhibitors on the daily profile of blood pressure and somnological characteristics in elderly patients with combined cardiac pathology. Medical News of North Caucasus. 2019;14 (3):448–453. DOI: 10.14300/mnnc.2019.14108
21. Malik S., Suchal K., Khan S., Bhatia J., Kishore K., Dinda A., et al. Apigenin ameliorates streptozotocininduced diabetic nephropathy in rats via MAPK-NF-κbtnf-α and TGF-β1-MAPK-fibronectin pathways. Am J Physiol Renal Physiol. 2017;313 (2): F414-F422. DOI: 10.1152/ajprenal.00393.2016.
22. Шляхто Е. В., Конради О. А., Арутюнов Г. П., Арутюнов А. Г., Баутин А. Е, Бойцов С. А. И др. Руководство по диагностике и лечению болезней системы кровообращения в контексте пандемии COVID-19. Российский кардиологический журнал. 2020;25 (3):3801. DOI: 10.15829/1560-4071-2020-3-3801
23. Reiter R., Abreu-Gonzalez P., Marik P., dominguezrodriguez A. Therapeutic Algorithm for Use of Melatonin in Patients With COVID-19. Front. Med. 2000;7:226. DOI: 10.3389/fmed.2020.00226
24. Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. European guideline for the diagnosis and Treatment of insomnia. J Sleep Res. 2017 26 (6):675–700. DOI: 10.1111/jsr.12594.
25. Чесникова А. И., Кошенская И. Н., Терентьев В. П., Можаева Н. Н., Бедарева И. В., Лаврик Л. А., и др. Эффективность рамиприла у больных артериальной гипертонией в сочетании с ишемической болезнью сердца. Рациональная фармакотерапия в кардиологии. 2008;4 (2):41–46. DOI: 10.20996/1819-6446-2008-4-2–41-46
26. Laudon M., Frydman-Marom A. Therapeutic effects of melatonin receptor agonists on sleep and comorbid disorders. Int J Mol Sci. 2014;15 (9):15924–50. DOI: 10.3390/ijms150915924.
27. Gombert M., Codoner-Franch P. Melatonin in Early Nutrition: Long-Term Effects on Cardiovascular System. Int J Mol Sci. 2021;22 (13):6809. DOI: 10.3390/ijms22136809.
28. Cardinali D. P. Melatonin and healthy aging. Vitam Horm. 2021;115:67–88. DOI: 10.1016/bs.vh.2020.12.004.
29. Цветкова Е. С., Романцова Т. И., Полуэктов М. Г., Рунова Г. Е., Глинкина И. В., Фадеев В. В. Значение мелатонина в регуляции метаболизма, пищевого поведения, сна и перспективы его применения при экзогенно-конституциональном ожирении. Ожирение и метаболизм. 2021;18 (2):112–124. DOI: 10.14341/omet12279
30. Liu J., Clough S., Hutchinson A., Adamah-Biassi E. B., Popovska-Gorevski M., Dubocovich M. L. MT1 and MT2 Melatonin Receptors: A Therapeutic Perspective. Annu Rev Pharmacol Toxicol. 2016;56:361–83. DOI: 10.1146/annurev-pharmtox-010814-124742.
31. Dumor K., Shoemaker-Moyle M., Nistala R., whaleyconnell A. Arterial Stiffness in Hypertension: an Update. Curr Hypertens Rep. 2018;20 (8):72. DOI: 10.1007/s11906-018-0867-x.
Review
For citations:
Vasilieva I.N., Chesnikova A.I., Klimenkova O.S., Bikmetova A.M. Evaluation of the effectiveness of drug treatment in patients with arterial hypertension and insomnia. South Russian Journal of Therapeutic Practice. 2021;2(4):49-59. (In Russ.) https://doi.org/10.21886/2712-8156-2021-2-4-49-59
Views:
920
Email this article 