20 December 2018 : Clinical Research
Effects of Chronic Intractable Insomnia on Inflammatory Cytokines, Blood Pressure Characteristics, and Antihypertensive Efficacy in Hypertensive PatientsYonghua Lu1DE, Xin Wang2BG, Guipeng Yang3BF, Xiaoyan Liu4CD, Maolin Xu5AC*
Med Sci Monit 2018; 24: CLR9259-9264
BACKGROUND: This study investigated the changes in blood pressure and inflammatory cytokines in patients with chronic intractable insomnia, and explored the effects of chronic intractable insomnia on antihypertensive efficacy.
MATERIAL AND METHODS: A total of 248 patients with hypertension admitted to our hospital from 2008 to 2017 were enrolled. We enrolled 124 patients without chronic insomnia in the control group, while 124 patients with chronic insomnia were included in the treatment group. The treatment group received estazolam and was further subdivided into the effective group (n=96) and the ineffective group (n=28) according to Sleep Dysfunction Rating Scale (SDRS) scores. Sleep quality before and after treatment was determined.
RESULTS: Antihypertensive treatment with eplerenone (50 mg) significantly reduced SDRS scores, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9), serum intercellular adhesion molecules (sICAM), and IL-1β levels, as well as systolic blood pressures (SBP) and diastolic blood pressures (DBP), with elevation of non-dipper blood pressure rhythm (P<0.05). The inhibition of intractable insomnia significantly downregulated SBP and DBP, as well as serum inflammatory cytokines such as CRP and TNF-α, showing a favorable effect on antihypertensive function.
CONCLUSIONS: Alleviation of chronic intractable insomnia facilitates hypertension therapy through decreasing levels of inflammatory cytokines and the proportion of non-dipper blood pressure rhythm, which offers insights for the treatment of hypertension.
Keywords: Circadian Rhythm, Cytokines, Hypertension
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