| Sažetak | Uvod i ciljevi istraživanja: Upala se smatra ključnim modulatorom u multimehanicističkoj patofiziologiji esencijalne hipertenzije te se stoga sve više stavlja u centar istraživačkih pitanja. S obzirom da liječenje hipertenzije nije zadovoljavajuće u velikog broja bolesnika, korištenje prehrambenih suplemenata poput CBD-a, neopijajućeg sastojka konoplje, bi moglo pozitivno utjecati na zbrinjavanje ovog velikog javnozdravstvenog problema. Također zbog širokog spektra djelovanja CBD-a od značaja bi bilo istražiti povezanost s HRV-om koji je već duže vrijeme etablirani, ekonomski dostupan, biomarker autonomne disfunkcije. Shodno tome, cilj ovog istraživanja bio je ustanoviti podudarnost dinamike serumskih koncentracija citokina i dijastoličkog tlaka uslijed petotjedne oralne suplementacije CBD-om te ustanoviti korelaciju HRV-a s primjenom CBD-om, također u trajanju od 5 tjedana. Ispitanici i postupci: U naše randomizirano križno istraživanje bilo je uključeno je 65 ispitanika s 1. i 2. stupnjom arterijske hipertenzije koji su prvih 5 tjedana primali CBD s posljedičnim dvotjednim ispiranjem kojem je slijedilo petotjedno primanje placeba. Korištene su standardizirane metode za prikupljanje podataka, uključujući detaljne medicinske anamneze, laboratorijske analize, kontinuirano mjerenje krvnog tlaka, snimanje elektrokardiograma i fizikalne preglede. Rezultati: Rezultati istraživanja pokazali su da je petotjedna oralna suplementacija CBD-om, ali ne i placebom, dovela do sniženja serumske koncentracije IL-8 (0,29 [10,85–19,05] vs. 0,26 [0,21– 0,38] pg/mL, P = 0,044), IL-10 (0,29 [0,23–0,37] vs. 0,23 [0,19–0,26] ng/mL, P < 0,001) i IL-18 (8,00 [5,47–11,24] vs. 5,09 [3,40–7,23] pg/mL, P < 0,001). S druge strane, serumske koncentracije PAI-1, LOX-1 i TNF-α nisu pokazale značajnu promjenu tijekom razdoblja primjene CBD-a ili placeba (P = 0,229, P = 0,943 i P = 0,061, redom). Konačno, nisu uočene značajne promjene varijabli mjerenja HRV-a odnosno LF/HF omjera, SDNN-a intervala te njihova korelacija s razinama upalnih parametara kod hipertenzivne populacije uslijed petotjedne suplementacije CBD-om. Zaključak: Istraživanje je pokazalo da suplementacija CBD-om može modulirati upalni odgovor koji je važan u složenoj patofiziologiji esencijalne hipertenzije te služi temelj za daljnja istraživanja o korištenju CBD-a kao dodatka standardnim terapijskim modalitetima u zbrinjavanju hipertenzije. |
| Sažetak (engleski) | Background and aim: Inflammation is considered a crucial modulator in the multimechanistic pathophysiology of essential hypertension and is therefore becoming a focal point when it comes to research questions. Given that the treatment of hypertension is not satisfactory in many patients, the use of dietary supplements such as CBD, a non-intoxicating component of marijuana, could have a positive effect on the management of this major public health issue. Also, due to the wide range of effects of CBD, it would be extremely important to find a correlation with HRV, which has been an established, economically available, biomarker of autonomic dysfunction last few decades. Accordingly, the aim of this study was to determine the connection between the dynamics of serum cytokine concentrations and diastolic pressure following a five-week oral administration of CBD, and to establish the correlation between HRV and CBD supplementation, for a duration of 5 weeks. Subject and methods: In our randomized crossover study, 65 subjects with 1st and 2nd degree arterial hypertension were included. They received CBD for 5 weeks, followed by 2 weeks washout period and placebo for another 5 weeks. Standardized data collection methods were used, including detailed medical histories, laboratory tests, ambulatory blood pressure measurement, electrocardiogram recordings and physical examinations. Results: The results of the study showed that a five-week oral supplementation with CBD, but not with placebo, had a significant impact on the change in the inflammatory response in patients with essential hypertension. In the experimental group, there was a decrease in the serum concentration of IL-8 (0.29 [10.85–19.05] vs. 0.26 [0.21–0.38] pg/mL, P = 0.044), IL- 10 (0.29 [0.23–0.37] vs. 0.23 [0.19–0.26] ng/mL, P < 0.001) and IL-18 (8.00 [5.47–11 .24] vs. 5.09 [3.40–7.23] pg/mL, P < 0.001) compared to the control group. Furthermore, serum concentrations of PAI-1, LOX-1, and TNF-α showed no significant change during the CBD or placebo administration period (P = 0.229, P = 0.943, and P = 0.061, respectively). On the other hand, no significant changes were observed in the measurement variables of HRV, i.e. LF/HF ratio, SDNN or the correlation with the blood levels of inflammatory parameters in the hypertensive population following a five-week supplementation with CBD. Conclusion: The research has shown that CBD supplementation may modulate the inflammatory response which plays a pivotal role in the complex pathophysiology of essential hypertension. This provides a foundation for further studies on the use of CBD as an additional treatment to standard therapeutic methods in managing hypertension. |
