| Abstract | Uvod: Posljednjih je godina uloga disfunkcije simpatičkog živčanog sustava u esencijalnoj hipertenziji (EH) privukla posebnu pozornost. Unatoč tome što je uključenost katestatina, etabliranog inhibitora simpatičke aktivnosti, u patogenezu EH već sada neosporna, kliničke studije o katestatinu u EH još uvijek nisu brojne. Nadalje, više je autora pokazalo da kanabidiol (CBD), neopijajući sastojak kanabisa, ima različite pozitivne učinke na regulaciju kardiovaskularnog sustava. Stoga, cilj ovog istraživanja bio je usporediti serumske koncentracije katestatina između bolesnika s EH i zdravih kontrola te utvrditi povezanost dinamike serumskih koncentracija katestatina i arterijskog tlaka uslijed petotjedne oralne administracije CBD-a.
Ispitanici i postupci: U presječno istraživanje uključeno je ukupno 72 ispitanika s EH, uz 72 kontrolna ispitanika. U randomiziranu križnu studiju uključeno je 54 ispitanika s EH, a ispitanici su 5 tjedana primali CBD, a 5 tjedana placebo. Svi uključeni sudionici bili su podvrgnuti uzimanju detaljne medicinske anamneze i dnevnih navika, kontinuiranom mjerenju arterijskog tlaka te uzorkovanju krvi za biokemijsku analizu.
Rezultati: U bolesnika s EH koncentracije katestatina u serumu bile su značajno više u usporedbi sa zdravim kontrolama (29,70 (19,33 – 49,48) ng/mL vs. 5,83 (4,21 – 8,29) ng/mL, P < 0,001). Neliječeni bolesnici imali su značajno više koncentracije katestatina u serumu od bolesnika liječenih antihipertenzivima (41,61 (22,85 – 63,83) ng/mL vs. 24,77 (16,41 – 40,21) ng/mL, P = 0,005). Petotjedna primjena CBD-a, ali ne i placeba, smanjila je koncentraciju katestatina u serumu u usporedbi s početnom vrijednošću (13,50 (10,85 – 19,05) vs. 9,65 (6,37 – 12,26) ng/mL, P < 0,001). Razine katestatina u serumu na početku razdoblja negativno su korelirale sa smanjenjem srednjeg arterijskog tlaka (r = -0,474, P < 0,001).
Zaključak: Istraživanje je pokazalo da je koncentracija katestatina u serumu povećana u EH, pretežno u neliječenoj podskupini, i da povezanost katestatatin s 24-satnim vrijednostima krvnog tlaka i značajkama arterijske krutosti govori o ulozi ovog peptida u EH. |
| Abstract (english) | Introduction: In recent years, the role of sympathetic nervous system dysfunction in essential hypertension (EH) has attracted special attention. Despite the fact that the involvement of catestatin, an established inhibitor of sympathetic activity, in the pathogenesis of EH is already indisputable, clinical studies on catestatin in EH are still not numerous. Furthermore, several authors have shown that cannabidiol (CBD), a non-intoxicating ingredient of cannabis, has various positive effects on the regulation of the cardiovascular system. Therefore, the aim of this study was to compare the serum concentrations of catestatin between patients with EH and healthy controls, and to determine the relationship between the dynamic of serum catestatin concentrations and arterial pressure following a five-week oral administration of CBD.
Subjects and methods: A total of 72 subjects with EH, along with 72 control subjects, were included in the cross-sectional study, whereas 54 subjects with EH were included in the randomized crossover study. In the second study, subjects received CBD for 5 weeks, and placebo for 5 weeks. All included participants were subjected to taking a detailed medical history and daily habits, ambulatory blood pressure measurement and blood sampling for biochemical analysis.
Results: In patients with EH, catestatin serum concentrations were significantly higher compared to healthy controls (29.70 (19.33 – 49.48) ng/mL vs. 5.83 (4.21 – 8.29) ng/mL, P < 0.001). Untreated patients had significantly higher serum catestatin concentrations than patients treated with antihypertensive drugs (41.61 (22.85 – 63.83) ng/mL vs. 24.77 (16.41 – 40.21) ng/mL, P = 0.005). Following 5-week administration of CBD, but not of placebo, has reduced serum catestatin concentration in comparison to baseline state (13.50 (10.85 – 19.05) vs. 9.65 (6.37 – 12.26) ng/mL, P < 0.001). Furthermore, serum catestatin concentrations at the start of the treatment period demonstrated a negative correlation with the extent of reduction in mean arterial pressure (r = -0.474, P < 0.001).
Conclusion: Our research has shown that serum catestatin concentrations are increased in EH, predominantly in the untreated subgroup, and that its association with 24-hour blood pressure values and arterial stiffness features suggests a role for this peptide in EH. |
