Melatonin and Human Cardiovascular Disease

The possible therapeutic role of melatonin in the pathophysiology of coronary artery disorder (CAD) is increasingly being recognized. In humans, exogenous melatonin has been shown to decrease nocturnal hypertension, improve systolic and diastolic blood pressure, reduce the pulsatility index in the internal carotid artery, decrease platelet aggregation, and reduce serum catecholamine levels. Low circulating levels of melatonin are reported in individuals with CAD, arterial hypertension, and congestive heart failure. This review assesses current literature on the cardiovascular effects of melatonin in humans. It can be concluded that melatonin deserves to be considered in clinical trials evaluating novel therapeutic interventions for cardiovascular disorders.Fil: Pandi Perumal, Seithikurippu R.. King Saud University; Arabia SauditaFil: BaHammam, Ahmed S.. King Saud University; Arabia SauditaFil: Ojike, Nwakile I.. King Saud University; Arabia SauditaFil: Akinseye, Oluwaseun A.. University of New York; Estados UnidosFil: Kendzerska, Tetyana. Sunnybrook Health Sciences Center; CanadáFil: Buttoo, Kenneth. Sleep Disorders Center; CanadáFil: Dhandapany, Perundurai S.. Oregon Health And Science University; Estados UnidosFil: Brown, Gregory M.. University of Toronto; CanadáFil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina ; Argentin

Pharmacotherapy of Insomnia

Insomnia remains a common clinical concern that is associated with negative daytime consequences for patients and represents a significant public health problem for our society. Although a variety of therapies may be employed to treat insomnia, the use of medications has been a dominant approach. Regulatory agencies have now classified insomnia medications into 4 distinct pharmacodynamics classes. Medications with indications approved for insomnia treatment include benzodiazepine receptor agonists, a melatonin receptor agonist, a selective histamine receptor antagonist, and a dual orexin/hypocretin receptor antagonist. Both pharmacodynamic and pharmacokinetic advances with hypnotic medications in recent years have expanded the pharmacopoeia to allow personalized treatment approaches for different patient populations and individual sleep disturbance patterns