N-[2-(5-methoxy-1H-indole-3-yl)ethyl]acetamide May Correct Arterial
Hypertension in People with Sleep Problems

 

Mikhail A. Osadchuk¹, Inna N. Vasilieva¹, Ekaterina D. Mironova¹, Nikolay P. Korzhenkov¹, Maxim V. Trushin²

 

¹Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov,
First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenovskiy University), Moscow, Russia
²Kazan Federal University, Kazan, Russia

 

SUMMARY

 

Introduction. Sleep disturbance is a frequent complaint of patients suffering from arterial hypertension (AH) for a long time. A hidden and uncontrolled increase in blood pressure (BP) makes the course of physiological processes more difficult, disrupts the regulation of biological rhythms, and increases the risk of cardiovascular complications even with a short duration of AH. At the same time, chronic sleep disorders contribute to the development of hypertension, defining the role of a new socially significant risk factor. An important role in the pathogenesis of insomnia is played by a deficiency in melatonin (MT) synthesis, which negatively affects the cardiovascular system (CVS).

Aim. The aim of the paper was to study the features of central and vascular hemodynamics in patients with the 1^st degree AH and to evaluate the clinical effectiveness of antihypertensive therapy with synthetic analog of prolonged-release MT at the onset of the disease.

Methods. Instrumental examination included registration of an electrocardiogram, office measurement of blood pressure with an automatic tonometer, non-invasive automatic blood pressure monitoring for 24 hours. The severity of insomnia was assessed by somnological questionnaires. Representatives of the 1^st group (n = 34) took monotherapy with the ACE inhibitor ramipril, participants of the 2^nd group (n = 33) took the ACE inhibitor ramipril in combination with a synthetic analogue of melatonin.

Results. The results of a randomized open prospective study including 78 participants reveal the activity of the renin-angiotensin-aldosterone system (RAAS), hypersympathicotonia at night and desynchronosis due to a possible deficiency in the MT secretion. Pharmacological antihypertensive therapy with the addition of prolonged release MT analog was accompanied by a significant improvement in the clinical condition of hypertensive patients. Positive dynamics of indicators of systemic hemodynamics and functional arterial parameters of stiffness was noted.

Conclusion. The article describes the probable benefits of melatonin as part of combination antihypertensive therapy in patients with early-stage hypertension and insomnia. Additional introduction of MT at the onset of the АН as a physiological regulator of circadian biological rhythms is substantiated.

 

Key words: insomnia, sleep disturbance, blood pressure, ambulatory blood pressure mo

Corresponding author:

Maxim Trushin

e-mail: mtrushin@mail.ru