Melatonin Reduces Night Blood Pressure in Patients with Nocturnal Hypertension

Grossman, Ehud; Laudon, Moshe; Yalçın, Rıdvan; Zengil, Hakan; Peleg, Edna; Sharabi, Yehonatan; Kamari, Yehuda; Shen‐Orr, Zila; Zisapel, Nava

doi:10.1016/j.amjmed.2006.02.002

Cited by 156 publications

(109 citation statements)

References 8 publications

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“…[20][21][22][23][24] These observations, of a direct effect of melatonin on BP, strongly support the notion that the impaired melatonin secretion favors predisposition to an abnormal circadian BP rhythm and is a cause of the nondipping pattern of BP.…”

Section: Discussionsupporting

confidence: 67%

“…Pinealectomy of laboratory rats results in hypertension, 18 while the hypertensive effect of pinealectomy is blocked by administration of exogenous melatonin. 19 In humans, administration of exogenous melatonin decreases BP in normotensive patients, 20,21 in patients with essential hypertension 22,23 and adolescents with diabetes mellitus type 1. 24 Recent reports have suggested that melatonin is also a significant modulator of immune response 25 and a physiologically important antioxidant.…”

Section: Introductionmentioning

confidence: 99%

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Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

et al. 2014

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Non-dipping circadian blood pressure (BP) is a common finding in preeclampsia, accompanied by adverse outcomes. Melatonin plays pivotal role in biological circadian rhythms. This study investigated the relationship between melatonin secretion and circadian BP rhythm in preeclampsia. Cases were women with preeclampsia treated between January 2006 and June 2007 in the University Hospital of Larissa. Volunteers with normal pregnancy, matched for chronological and gestational age, served as controls. Twenty-four hour ambulatory BP monitoring was applied. Serum melatonin and urine 6-sulfatoxymelatonin levels were determined in day and night time samples by enzyme-linked immunoassays. Measurements were repeated 2 months after delivery. Thirty-one women with preeclampsia and 20 controls were included. Twenty-one of the 31 women with preeclampsia were non-dippers. Compared to normal pregnancy, in preeclampsia there were significantly lower night time melatonin (48.4 ± 24.7 vs. 85.4 ± 26.9 pg/mL, p50.001) levels. Adjustment for circadian BP rhythm status ascribed this finding exclusively to non-dippers (p50.01). Two months after delivery, in 11 of the 21 non-dippers both circadian BP and melatonin secretion rhythm reappeared. In contrast, in cases with retained non-dipping status (n ¼ 10) melatonin secretion rhythm remained impaired: daytime versus night time melatonin (33.5 ± 13.0 vs. 28.0 ± 13.8 pg/mL, p ¼ 0.386). Urinary 6-sulfatoxymelatonin levels were, overall, similar to serum melatonin. Circadian BP and melatonin secretion rhythm follow parallel course in preeclampsia, both during pregnancy and, at least 2 months after delivery. Our findings may be not sufficient to implicate a putative therapeutic effect of melatonin, however, they clearly emphasize that its involvement in the pathogenesis of a non-dipping BP in preeclampsia needs intensive further investigation.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

et al. 2014

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“…69 In addition, melatonin supplementation or supplementation with its receptor agonists has been shown to lower nocturnal BP in hypertensive patients. 70,71 These may be novel complementary or alternative approaches to lowering nocturnal BP; however, the mechanisms and targets of circadian BP regulation by melatonin, that is, central or peripheral action, remain obscure.…”

Section: Treatment Of Nocturnal Bp Increasesmentioning

confidence: 99%

Nocturnal blood pressure and cardiovascular disease: a review of recent advances

2012

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The accurate measurement, prediction and treatment of high blood pressure (BP) are essential issues in the management of hypertension. Ambulatory blood pressure monitoring (ABPM) has been shown to be superior to clinic BP measurements as ABPM can provide the following important information: (i) the mean BP levels, (ii) the diurnal variation in BP and (iii) the short-term BP variability. Among these parameters, there is increasing evidence that the mean nocturnal BP level is the most sensitive predictor of cardiovascular morbidity and mortality. Furthermore, several studies have shown that less nocturnal BP dipping, defined as less nocturnal BP decline relative to daytime BP, or a high night-day BP ratio was associated with poor prognosis irrespective of the 24-hour BP levels. These findings can be interpreted in at least two ways: namely, high nocturnal BP or less nocturnal BP dipping might be not only a potent risk factor for cardiovascular disease (CVD), but also a marker of pre-existing or concurrent diseases that can lead to nocturnal BP elevation. In this review, we consider the clinical utility of ABPM and in particular focus on the nocturnal BP levels or nocturnal BP dipping as a potent risk factor for CVD. In addition, the clinical management of high nocturnal BP and blunted nocturnal BP dipping with antihypertensive medications is discussed.

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Section: Introductionmentioning

confidence: 99%

“…2 Melatonin decreased BP in hypertensive patients, 3 and the addition of melatonin to antihypertensive medication in patients with nocturnal hypertension reduced nighttime systolic BP. 4 However, the mechanisms behind melatonin's effect on BP are still not completely understood.The hypotensive effect of melatonin could be mediated either by a direct effect on vessels or by decreasing brain serotonin release, resulting in sympathetic inhibition or parasympathetic stimulation. 5 There are rather limited data about changes of melatonin concentrations related to essential hypertension in the literature.…”

mentioning

confidence: 99%

Effect of L-NAME-induced hypertension on melatonin receptors and melatonin levels in the pineal gland and the peripheral organs of rats

et al. 2009

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Melatonin plays a role in blood pressure (BP) control. The aim of this study was to determine whether melatonin concentrations and melatonin receptor levels are altered in L-NAME-treated, NO-deficient hypertensive rats. Two groups of male adult Wistar rats were investigated: rats (n¼36) treated with NO-synthase inhibitor L-NAME (40 mg kg À1 ) and age-matched controls (n¼36). BP was measured weekly by tail-cuff plethysmography. After 4 weeks, L-NAME administration increased BP (178±1 vs. control 118 ± 1 mm Hg). At the end of treatment, rats were killed in regular 4 h intervals over a 24-h period. Melatonin concentrations in the plasma, pineal gland, heart and kidney and melatonin receptor (MT 1 ) density in the aorta were determined. A significant daily rhythm of melatonin concentrations was found in the blood, pineal gland, kidney and heart of both control and hypertensive rats. Peak nighttime pineal melatonin concentrations were higher in L-NAME-treated rats than in controls (3.38 ± 0.48 vs. 1.75 ± 0.33 ng per pineal gland). No differences between both groups were found in melatonin concentrations in blood, kidney and heart or in the MT 1 receptor density in the aorta. Our results suggest that L-NAME treatment enhances melatonin production in the pineal gland, potentially by decreasing an inhibitory effect of NO on melatonin production in the pineal gland. However, the enhanced pineal melatonin formation was insufficient to increase melatonin concentrations in circulation, heart and kidney of L-NAME-treated rats, indicating an increased use of melatonin in hypertensive animals. INTRODUCTIONMelatonin is a hormone produced by the pineal gland in a circadian manner and exhibits a broad spectrum of effects, including those in the cardiovascular system. Melatonin has been suggested to play a role in blood pressure (BP) control. Earlier reports have shown that pinealectomized rats developed hypertension, 1 and the administration of melatonin in this model normalized the increased BP. 2 Melatonin decreased BP in hypertensive patients, 3 and the addition of melatonin to antihypertensive medication in patients with nocturnal hypertension reduced nighttime systolic BP. 4 However, the mechanisms behind melatonin's effect on BP are still not completely understood.The hypotensive effect of melatonin could be mediated either by a direct effect on vessels or by decreasing brain serotonin release, resulting in sympathetic inhibition or parasympathetic stimulation. 5 There are rather limited data about changes of melatonin concentrations related to essential hypertension in the literature. Plasma melatonin and urinary 6-sulfatoxymelatonin levels have been reported

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Melatonin Reduces Night Blood Pressure in Patients with Nocturnal Hypertension

Cited by 156 publications

References 8 publications

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

Nocturnal blood pressure and cardiovascular disease: a review of recent advances

Effect of L-NAME-induced hypertension on melatonin receptors and melatonin levels in the pineal gland and the peripheral organs of rats

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