Effect of amlodipine on the manifestations of chronic insomnia in hypertensive patients with type 2 diabetes mellitus
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Abstract
Background: The aim of the study was to assess the association between antihypertensive therapy and the manifestations of insomnia in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM).
Material and methods: The study included 120 hypertensive patients with and without T2DM (among them there were 60 patients with insomnia). The study consisted of three stages. The first stage was conducted as a cross-sectional study, during which an association was established between different antihypertensive products and the presence of insomnia in the study population. The second and third stages were a prospective study, during which a modification of the therapy to reduce the manifestations of insomnia was performed.
Results: It was found that patients receiving amlodipine in the combination antihypertensive therapy had insomnia manifestations much less frequently as compared to indapamide. A statically significant decrease in blood pressure (BP) and a higher proportion of patients with target BP were observed in both groups. Replacement of indapamide with amlodipine was shown to improve sleep quality. Thus, the number of patients with insomnia significantly decreased in both groups. After correction of antihypertensive therapy after 12 months, all patients were assessed for sleep disorders. The incidence of insomnia was found to be significantly reduced in both groups after changing therapy from indapamide to amlodipine.
Conclusions: Correction of antihypertensive therapy, namely the replacement of indapamide with amlodipine, contributes to an improvement in BP, quality of life, and a reduction in the proportion of patients with insomnia.
Keywords: insomniaarterial hypertensiontype 2 diabetes mellitusamlodipine
References
- Vgontzas AN, Liao D, Pejovic S, et al. Insomnia with short sleep duration and mortality: the Penn State cohort. Sleep. 2010; 33(9): 1159–1164.
- Eguchi K, Pickering TG, Schwartz JE, et al. Short sleep duration as an independent predictor of cardiovascular events in Japanese patients with hypertension. Arch Intern Med. 2008; 168(20): 2225–2231.
- Patel SR, Ayas NT, Malhotra MR, et al. A prospective study of sleep duration and mortality risk in women. Sleep. 2004; 27(3): 440–444.
- Kronholm E, Laatikainen T, Peltonen M, et al. Self-reported sleep duration, all-cause mortality, cardiovascular mortality and morbidity in Finland. Sleep Med. 2011; 12(3): 215–221.
- Taylor DJ, Mallory LJ, Lichstein KL, et al. Comorbidity of chronic insomnia with medical problems. Sleep. 2007; 30(2): 213–218.
- Jarrin DC, Alvaro PK, Bouchard MA, et al. Insomnia and hypertension: a systematic review. Sleep Med. 2017; 40: e147.
- Li M, Yan S, Jiang S, et al. Relationship between sleep duration and hypertension in northeast China: a cross-sectional study. BMJ Open. 2019; 9(1): e023916.
- Fernandez-Mendoza J, Vgontzas AN, Liao D, et al. Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort. Hypertension. 2012; 60(4): 929–935.
- Lin CL, Liu TC, Lin FH, et al. Association between sleep disorders and hypertension in Taiwan: a nationwide population-based retrospective cohort study. J Hum Hypertens. 2017; 31(3): 220–224.
- Wang YM, Song M, Wang R, et al. Insomnia and Multimorbidity in the Community Elderly in China. J Clin Sleep Med. 2017; 13(4): 591–597.
- Bathgate CJ, Fernandez-Mendoza J. Insomnia, Short Sleep Duration, and High Blood Pressure: Recent Evidence and Future Directions for the Prevention and Management of Hypertension. Curr Hypertens Rep. 2018; 20(6): 52.
- Petrov ME, Howard VJ, Kleindorfer D, et al. Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study. J Stroke Cerebrovasc Dis. 2014; 23(8): 2110–2116.
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. J Hypertens. 2018; 36(10): 1953–2041.
- Unifikovanyi klinichnyi protokol pervynnoi ta vtorynnoi (spetsializovanoi) medychnoi dopomohy: tsukrovyi diabet 2 typu (nakaz MOZ №1118 vid 21.12.2012 r. [In Ukrainian].
- American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. American Academy of Sleep Medicine, Darien 2014.
- Carter JR, Grimaldi D, Fonkoue IT, et al. Assessment of sympathetic neural activity in chronic insomnia: evidence for elevated cardiovascular risk. Sleep. 2018; 41(9).
- Tamisier R, Weiss JW, Pépin JL. Sleep biology updates: Hemodynamic and autonomic control in sleep disorders. Metabolism. 2018; 84: 3–10.
- Tanabe N, Fujita T, Fujii Y, et al. [Investigation of the factors that contribute to the onset of insomnia in hypertensive patients by using a post-marketing surveillance database]. Yakugaku Zasshi. 2011; 131(5): 669–677.
- Chang CH, Yang YHK, Lin SJ, et al. Risk of insomnia attributable to β-blockers in elderly patients with newly diagnosed hypertension. Drug Metab Pharmacokinet. 2013; 28(1): 53–58.
- Haaramo P, Rahkonen O, Hublin C, et al. Insomnia symptoms and subsequent cardiovascular medication: a register-linked follow-up study among middle-aged employees. J Sleep Res . 2014; 23(3): 281–289.
- Winkelman JW, Benca R, Eichler AF. Overview of the treatment of insomnia in adults. https://www.uptodate.com/contents/overview-of-the-treatment-of-insomnia-in-adults.
- Sato A, Fukuda S. A prospective study of frequency and characteristics of cough during ACE inhibitor treatment. Clin Exp Hypertens. 2015; 37(7): 563–568.
- Lu Y, Wang X, Yang G, et al. Effects of Chronic Intractable Insomnia on Inflammatory Cytokines, Blood Pressure Characteristics, and Antihypertensive Efficacy in Hypertensive Patients. Med Sci Monit. 2018; 24: 9259–9264.