Коморбидные инсомния и артериальная гипертензия: патогенетические модели и перспективные биомаркеры

В данной обзорной статье описаны основные механизмы возникновения и поддержания коморбидных инсомнии и артериальной гипертензии с учетом актуальных патогенетических сценариев инсомнии, включающих концепцию симпатической активации, нейробиологическую модель инсомнии и трехфакторную модель. Результаты единичных клинических исследований свидетельствуют о взаимосвязи уровней артериального давления с гиперактивацией центральной нервной системы во время сна, характеризуемой по электроэнцефалографической активности в диапазоне β-спектра, и с показателями латентности сна. Тем не менее биологически активные вещества, опосредующие так называемое «нейрогенное воспаление», также играют значимую роль в поддержании гомеостаза при воздействии эндогенных и экзогенных стрессорных факторов. Функции интерлейкина‑6, гамма-аминомасляной кислоты, субстанции Р, мелатонина, серотонина и орексина в норме и в патологии позволяют высказать предположение об их участии в механизмах реализации взаимосвязи инсомнии и артериальной гипертензии. Подчеркивается важность трактовки инсомнии в качестве отдельной нозологической единицы, сопутствующей артериальной гипертензии, и актуальность исследований молекулярных механизмов взаимосвязи инсомнии и артериальной гипертензии с целью определения перспективных терапевтических мишеней и прогностических маркеров при конкретном патогенетическом сценарии.

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