Артериальная гипертензия и инсомния
Артериальная гипертензия и инсомния
Остроумова Т.М., Парфенов В.А., Остроумова О.Д., Кочетков А.И. Артериальная гипертензия и инсомния. Терапевтический архив. 2020; 92 (1): 69–75. DOI: 10.26442/00403660.2020.01.000319
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Аннотация
Инсомния часто выявляется у пациентов с артериальной гипертензией (АГ): от 19 до 47,9% случаев по данным эпидемиологических исследований. С другой стороны, частота АГ у пациентов с инсомнией колеблется от 21,4 до 50,2%, тогда как у пациентов без инсомнии – от 11,0 до 41,8%. В единичных исследованиях, в которых пациентам с инсомнией проводилось суточное мониторирование артериального давления (СМАД), у этих больных выявлены более высокие уровни артериального давления (АД) в период сна. Согласно данным литературы, инсомния также является фактором риска развития АГ. Среди патогенетических механизмов, объясняющих взаимосвязь между АГ и инсомнией, обсуждаются повышение активности основных стрессовых нейроэндокринных систем, симпатоадреналовой и гипоталамо-гипофизарно-надпочечниковой, частое наличие сопутствующих тревожных расстройств. Для определения качества сна у пациентов с инсомнией чаще всего применяется Питтсбургский индекс качества сна (Pittsburgh Sleep Quality Index, PSQI), у больных АГ в ряде исследований обнаружен более высокий общий балл по PSQI по сравнению с лицами с нормальным АД. Количество баллов по данному опроснику коррелирует с уровнем систолического и диастолического АД, а также с наличием нон-диппер-типа суточного профиля АД. Как АГ, так и инсомнии ассоциируются с нарушением когнитивных функций. Однако данные литературы о взаимосвязи когнитивных нарушений и инсомнии достаточно противоречивы, что наиболее связано с методологией оценки когнитивных функций и различиями исходных клинико-демографических характеристик обследованного контингента больных.
Ключевые слова: артериальная гипертензия, суточное мониторирование артериального давления, инсомния, когнитивные нарушения.
Keywords: hypertension, ambulatory blood pressure monitoring, insomnia, cognitive impairment.
Ключевые слова: артериальная гипертензия, суточное мониторирование артериального давления, инсомния, когнитивные нарушения.
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Keywords: hypertension, ambulatory blood pressure monitoring, insomnia, cognitive impairment.
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4. Bochkarev MV, Korostovtseva LS, Filchenko IA, Rotar OP, Sviryaev YuV, Zhernakova YuV, et al. Social-demographic aspects of insomnia in the Russian population according to ESSE-RF study. Zhurnal nevrologii i psikhiatrii imeni SS Korsakova. Special issues. 2018;118(4):26-34 (In Russ.) doi: 10.17116/jnevro2018 1184226
5. Zhang B, Wing YK. Sex differences in insomnia: a meta-analysis. Sleep. 2006;29(1):85-93. doi: 10.1093/sleep/29.1.85
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7. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Hypertens J. 2013;31:1281-357. doi: 10.1093/eurheartj/eht151
8. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183-9. doi: 10.1097/00004872-20021100 0-00017
9. Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertens. 2001;38(4):852-7. doi: 10.1161/hy1001.092 640
10. Cuspidi C, Michev I, Meani S, Severgnini B, Fusi V, Corti C, et al. Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension. J Human Hypertens. 2003;17(4):245-51. doi: 10.1038/sj.jhh.1001546
11. Fagard RH, Celis H, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA. Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertens. 2008;51(1):55-61. doi:10.1161/hypertensionaha.107.100727
12. Dolan E, Stanton AV, Thom S, Caulfield M, Atkins N, McInnes G, et al. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients – an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens. 2009;27(4):876-85. doi: 10.1097/hjh.0b013e32 8322cd62
13. Sen P, Mukhopadhyay AK, Chatterjee P, Biswas T. Association of Sleep Disorders with Essential Hypertension in Subcontinental Population. Indian Medical Gazette, 2012:463-466.
14. Karnik R, Peethambaran K, Adsule S. A cross-sectional, multi-centric, epidemiology study to determine the prevalence of insomnia and related sleep habits in Indian hypertensive patients. Int J Research in Medical Sciences. 2017;5(3):787. doi: 10.18203/2320-6012.ijrms20170508
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20. Benbir G, Demir AU, Aksu M, Ardic S, Firat H, Itil O, et al. Prevalence of insomnia and its clinical correlates in a general population in Turkey. Psychiatry and Clinical Neurosciences. 2015;69(9):543-52. doi: 10.1111/ pcn.12252
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36. Irwin MR, Wang M, Ribeiro D, Cho HJ, Olmstead R, Breen EC, et al. Sleep loss activates cellular inflammatory signaling. Biological Psychiatry. 2008;64(6):538-40. doi: 10.1016/j.biopsych.2008.05.004
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39. Fernandez-Mendoza J, Vgontzas AN, Liao D, Shaffer ML, Vela-Bueno A, Basta M, Bixler EO. Insomnia with Objective Short Sleep Duration and Incident Hypertension. The Penn State Cohort. Hypertens. 2012;60(4):929-35. doi: 10.1161/hypertensionaha.112.193268
40. Wang Q, Xi B, Liu M, Zhang Y, Fu M. Short sleep duration is associated with hypertension risk among adults: a systematic review and meta- analysis. Hypertens Research. 2012;35(10):1012-8. doi: 10.1038/hr.2012.91
41. Meng L, Zheng Y, Hui R. The relationship of sleep duration and insomnia to risk of hypertension incidence: a meta-analysis of prospective cohort studies. Hypertens Research. 2013;36(11):985-95. doi: 10.1038/ hr.2013.70
42. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989;28(2):193-213. doi: 10.1016/0165-1781(89)90 047-4
43. Liu RQ, Qian Z, Trevathan E, Chang JJ, Zelicoff A, Hao YT, et al. Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: results from a large population-based study. Hypertens Research. 2016;39(1):54-9. doi: 10.1038/hr.2015.98
44. Lu K, Ding RJ, Tang Q, Chen J, Wang L, Wang C, et al. Association between self- reported global sleep status and prevalence of hypertension in Chinese adults: data from the Kailuan community. Int J Environmental Research and Public Health. 2015;12(1):488-503. doi: 10.3390/ijerph120100488
45. Bruno RM, Palagini L, Gemignani A, Virdis A, Di Giulio A, Ghiadoni L, et al. Poor sleep quality and resistant hypertension. Sleep Medicine. 2013;14(11):1157-63. doi: 10.1016/j.sleep.2013.04.020
46. Kaya Z, Kayrak M, Demir K, Gündüz M, Alibasiç H, Karanfil M, et al. The relationship between white coat hypertension and sleep quality. Sleep and Biological Rhythms. 2014;12(3):203-11. doi: 10.1111/sbr.12070
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50. Ulu SM, Ulu S, Ulasli SS, Yaman G, Ahsen A, Ozkececi G, Yuksel S. Is impaired sleep quality responsible for a nondipping pattern even in normotensive individuals? Blood Pressure Monitoring. 2013;18(4):183-7. doi: 10.1097/mbp.0b013e3283624b03
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66. de Almondes KM, Costa MV, Malloy-Diniz LF, Diniz BS. Insomnia and risk of dementia in older adults: systematic review and meta-analysis. J Psychiatric Research. 2016;77:109-15. doi: 10.1016/j.jpsychires.2016.02. 021
Авторы
Т.М. Остроумова1, В.А. Парфенов1, О.Д. Остроумова1,2, А.И. Кочетков2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБОУ ВО «Российский научно-исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России – ОСП «Российский геронтологический научно-клинический центр», Москва, Россия
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Pirogov Russian National Research Medical University – Russian Clinical and Research Center of Gerontology, Moscow, Russia
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБОУ ВО «Российский научно-исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России – ОСП «Российский геронтологический научно-клинический центр», Москва, Россия
________________________________________________
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Pirogov Russian National Research Medical University – Russian Clinical and Research Center of Gerontology, Moscow, Russia
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