Zemlyanskaya N.A.,Shishko E.U., Kolbasina L.P.

Crimea state medical university named after S. I. Georgievsky, Simferopol.

The role of melatonin in adaptave potential in patients with essential hypertension

The vital activity of the body can be imagined as well-coordinated system of biological rhythms, from the subcellular level to organismal.This system always corrected by changes, occurring in the organism and environment.This ability to response to different endogenic and exogenic stimuli by biorhythms restructuring characterizes stability and health of human body.

The main messenger of endogenic rhythms is melatonin, the secretion which submit to circadian rhythm. This pineal hormone has rhythm control ritmo regulatory function, antioxidant, immunomodulating and other functions,which determine coordinated working of body systems.

Influence of meletonin on cardiovascular system manifested by decrease of systolic blood pressure at rest within the physiological rationality and reduce increase of systolic blood pressure during the psycho-emotional test, that shows the restriction of stress reaction of cardiovascular system.

On the basis of notions, that hypertonic disease(essential hypertension) in a certain sense is the disease of maladjustment, justified the study of melatonin production in this pathology.

When patients with hypertonic disease undergo rehabilitation in health resort conditions, the fact of moving to a new climate zone and change of regular regimen can caused the stress of adaptation processes and circadian disregulation.

The purpose of our investigation is optimization the adaptional period at the sanatorium rehabilitation of patients having hypertension by effects of melatonin on desynchronosis processes.

The investigation carried out on the basis of clinical sanatorium “Ukraine” (Yalta,Crimea) and department of laboratory studies of state educational, scientific and medical complex of clinic state institution “Crimea state medical university named after S. I. Georgievsky”.Were formed 4 group of examined patients:1st group – 15 male patients with hypertension stage II, the mean age was 52±6,24 years, 2nd group - 15 female patients with hypertension stage II, the mean age was 51±6,15 year; 2 control group: 1st – 15 healthy young people, the mean age was 24±3,11; 2nd – 14 almost healthy men without arterial hypertension and CHD symptoms, the mean age – 51±5,48 years.

Were tested melatonin in urine, collected in night time(from 21.00 to 6.00)

For estimation of cardiocascular system functioning level was determine the adaptation potential(AP), it's calculated in conditional points by formula, which includes blood pressure index(BP systolic vs diastolic ,mm Hg),heart rate(Bpm), age(A years), weight (W kg), height(H cm) and constant coefficient (K=0,27).

Statistical treatment of data performed by using Medstat with checkup received static series for normality,where ware calculated mean(M), the standard error of the mean(m), comparison of related and independent samples by Student's t-test(t).

In this way,the results of conducted investigation evidence that:

1.The decrease of adaptive possibility in male patients having hypertension accompanied by low nocturnal excretion of melatonin metabolite (6 - hydroxymethyllatoninsulfata (6–HMS))(p<,005) in comparison with control group. The female patients have more significant differences(p<0,001). After melatonin containing preparation using the difference of 6-HMS indexes in control and experimental group has leveled.

2 . In spite of difference of indexes of 6-HMS excretion in men and women the adaptive potential of cardiocascular system in both groups has improved(on 16,35% in men and on 16,07% in women) and remained optimal after discontinuation of medication in 84% of patients.

In this way, the adaptation of patients having hypertension to resort conditions accompanied by stress of regulatory system and mobilization of functional reserves, this manifested by significant distinction of cardiovascular system calculated values in patients relatively the control group.

The inclusion of melatonin in resort rehabilitation of patients suffering from hypertension stage II considering the gender differences and increase course dose for women is appropriate.