Controlled-release melatonin significantly reduced nocturnal systolic blood pressure (-6.1 mmHg; 95% CI -10.7 to -1.5; P=0.009), whereas fast-release melatonin had no significant effect.
Meta-Analysis (n=221)
Does exogenous melatonin reduce nocturnal blood pressure in patients with nocturnal hypertension?
Add-on controlled-release melatonin, but not fast-release melatonin, is effective and safe for reducing nocturnal blood pressure in patients with nocturnal hypertension.
Effect estimate: Mean difference -6.1 mmHg (95% CI -10.7 to -1.5)
p-value: p=0.009
BACKGROUND: Patients with nocturnal hypertension are at higher risk for cardiovascular complications such as myocardial infarction and cerebrovascular insult. Published studies inconsistently reported decreases in nocturnal blood pressure with melatonin. METHODS: A meta-analysis of the efficacy and safety of exogenous melatonin in ameliorating nocturnal blood pressure was performed using a random effects model of all studies fitting the inclusion criteria, with subgroup analysis of fast-release versus controlled-release preparations. RESULTS: Seven trials (three of controlled-release and four of fast-release melatonin) with 221 participants were included. Meta-analysis of all seven studies did not reveal significant effects of melatonin versus placebo on nocturnal blood pressure. However, subgroup analysis revealed that controlled-release melatonin significantly reduced nocturnal blood pressure whereas fast-release melatonin had no effect. Systolic blood pressure decreased significantly with controlled-release melatonin (-6.1 mmHg; 95% confidence interval CI -10.7 to -1.5; P = 0.009) but not fast-release melatonin (-0.3 mmHg; 95% CI -5.9 to 5.30; P = 0.92). Diastolic blood pressure also decreased significantly with controlled-release melatonin (-3.5 mmHg; 95% CI -6.1 to -0.9; P = 0.009) but not fast-release melatonin (-0.2 mmHg; 95% CI -3.8 to 3.3; P = 0.89). No safety concerns were raised. CONCLUSION: Add-on controlled-release melatonin to antihypertensive therapy is effective and safe in ameliorating nocturnal hypertension, whereas fast-release melatonin is ineffective. It is necessary that larger trials of longer duration be conducted in order to determine the long-term beneficial effects of controlled-release melatonin in patients with nocturnal hypertension.
Laudon et al. (Thu,) conducted a meta-analysis in Nocturnal hypertension (n=221). Melatonin (controlled-release and fast-release) vs. Placebo was evaluated on Nocturnal systolic blood pressure (controlled-release subgroup) (Mean difference -6.1 mmHg, 95% CI -10.7 to -1.5, p=0.009). Controlled-release melatonin significantly reduced nocturnal systolic blood pressure (-6.1 mmHg; 95% CI -10.7 to -1.5; P=0.009), whereas fast-release melatonin had no significant effect.
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