褪黑素昼夜节律及其调节:对高血压的可能影响。

Russel J Reiter, Dan-Xian Tan, Ahmet Korkmaz
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引用次数: 127

摘要

在实验啮齿类动物中,手术切除松果体(循环褪黑素的主要来源)会导致血压逐渐持续升高。相反,当长期给去松果体的啮齿动物服用褪黑素时,血压的升高得到了改善。在人类中也是如此,夜间内源性循环褪黑激素水平的上升可能与夜间血压的降低成反比。在高血压患者中,一些人在夜间表现出更大的血压下降(所谓的“极端小倾角”和“小倾角”),而另一些人在夜间只表现出轻微的收缩压和舒张压下降(“非小倾角”和“倒倾角”)。对这些患者的纵向研究表明,倒舀和不舀比舀和极端舀死亡的速度更快。高血压患者长期服用褪黑素可导致夜间收缩压和舒张压明显下降。此外,夜间内源性褪黑激素水平越高(根据尿中褪黑激素的代谢物,硫酸6-羟基褪黑激素估计),夜间动脉血压的降低幅度越大。这些发现暗示褪黑素可能作为一种降压药具有效用。
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The circadian melatonin rhythm and its modulation: possible impact on hypertension.

In experimental rodents, surgical removal of the pineal gland, the major source of circulating melatonin, causes a gradual and sustained rise in blood pressure. Conversely, when melatonin is chronically administered to pinealectomized rodents the increment in blood pressure is ameliorated. In humans as well, the night time rise in endogenous circulating melatonin levels may be inversely related to the reduction in night time blood pressure. Among patients with hypertension, some exhibit a much greater reduction in blood pressure at night (the so-called 'extreme dippers' and 'dippers'), whereas others exhibit only a slight night time reduction in systolic and diastolic pressure ('non-dippers' and 'inverted dippers'). Longitudinal studies of these patients show that inverted dippers and non-dippers die at a faster rate than do dippers and extreme dippers. The chronic administration of melatonin to individuals with hypertension induces a measurable drop in night time systolic and diastolic blood pressure. Moreover, the higher the night time level of endogenous melatonin (estimated from urinary metabolite of melatonin, 6-hydroxymelatonin sulphate), the greater the reduction in arterial blood pressure at night. The implication of these findings is that melatonin may have utility as an antihypertensive agent.

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